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General NPI Number Information
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NPI Number | 1588704217
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Entity Type | Individual
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Provider Name | CARLOS BARRETT ROCHA M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 02/05/2013
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Provider Practice Location Address
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Address Line | 400 CRESTWOOD CIR STE P
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City | MENA
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State | AR
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Zip | 71953-5512
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Country | US
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Telephone | 479-394-2534
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Fax | 479-394-7012
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Provider Business Mailing Address
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Address Line | 400 CRESTWOOD CIR STE P
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City | MENA
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State | AR
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Zip | 71953-5512
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Country | US
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Telephone | 479-394-2534
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Fax | 479-394-7012
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | E2878
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License Number State | AR
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