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General NPI Number Information
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NPI Number | 1609261338
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Entity Type | Individual
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Provider Name | DANIEL LEE PRICE MD
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Gender | Male
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Dates
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Enumeration Date | 03/31/2015
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Last Update Date | 06/01/2022
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Provider Practice Location Address
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Address Line | 611 COURT ST STE 9
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City | CONWAY
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State | AR
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Zip | 72032-5417
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Country | US
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Telephone | 501-205-4570
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2125
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City | BENTON
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State | AR
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Zip | 72018-2125
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Country | US
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Telephone | 501-205-4570
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | E-11941
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License Number State | AR
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