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General NPI Number Information
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NPI Number | 1033168489
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Entity Type | Organization
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Legal Business Name | ASSOCIATED PATHOLOGISTS LABORATORY PA
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 208 THOMPSON AVE
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City | EL DORADO
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State | AR
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Zip | 71730-5756
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Country | US
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Telephone | 870-862-1351
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Fax | 870-862-2815
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Provider Business Mailing Address
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Address Line | 208 THOMPSON AVE
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City | EL DORADO
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State | AR
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Zip | 71730-5756
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Country | US
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Telephone | 870-862-1351
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Fax | 870-862-2815
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | GARY P ANZALONE
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Credential | MD
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Telephone | 870-862-8046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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