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General NPI Number Information
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NPI Number | 1528055258
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Entity Type | Individual
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Provider Name | JUAN C ROMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 09/14/2018
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Provider Practice Location Address
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Address Line | 500 S UNIVERSITY AVE STE 214
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City | LITTLE ROCK
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State | AR
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Zip | 72205-5304
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Country | US
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Telephone | 501-476-3914
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Fax |
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Provider Business Mailing Address
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Address Line | 500 S UNIVERSITY AVE STE 214
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City | LITTLE ROCK
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State | AR
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Zip | 72205-5304
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Country | US
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Telephone | 501-476-3914
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | E-1764
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | E-1764
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License Number State | AR
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