Healthcare Provider Details
I. General information
NPI: 1316232648
Provider Name (Legal Business Name): BHAVIKA P ALBEE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/15/2011
Last Update Date: 10/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4010 S MULBERRY ST
PINE BLUFF AR
71603-7000
US
IV. Provider business mailing address
4010 S MULBERRY ST
PINE BLUFF AR
71603-7000
US
V. Phone/Fax
- Phone: 870-541-6008
- Fax: 870-541-3198
- Phone: 870-541-6008
- Fax: 870-541-3198
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | E-8384 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: