Healthcare Provider Details

I. General information

NPI: 1104153394
Provider Name (Legal Business Name): DOREEN SALTIEL, MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2009
Last Update Date: 02/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12112 HIGHWAY 71 SOUTH
FORT SMITH AR
72916-8405
US

IV. Provider business mailing address

12112 HIGHWAY 71 SOUTH
FORT SMITH AR
72916-8405
US

V. Phone/Fax

Practice location:
  • Phone: 479-434-5350
  • Fax: 479-434-5355
Mailing address:
  • Phone: 479-434-5350
  • Fax: 479-434-5355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License NumberE5746
License Number StateAR

VIII. Authorized Official

Name: DR. DOREEN SALTIEL
Title or Position: OWNER
Credential: MD
Phone: 479-434-5350