Revard, Ronald E

Revard, Ronald E is an individual health care provider with primary practice located at 702 N. Spring Street , Harrison AR 72601. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Revard, Ronald E can be contacted via phone (870) 365-0761.

Contact Information

Primary practice address
702 N. Spring Street Harrison AR 72601
Phone: (870) 365-0761
Fax: (870) 365-0763
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X C-6300 Arkansas
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X C6300 Arkansas

Profile Details

NPI number 1710970637
LBN Legal business name Revard, Ronald E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2005
Last updated Mar 12th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710970637 NPPES
Arkansas MEDICAID 110646001

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