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General NPI Number Information
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NPI Number | 1699162149
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Entity Type | Individual
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Provider Name | NATHAN SCHANDEVEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/22/2015
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 3201 SPRINGHILL DR STE 300
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72117-2909
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Country | US
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Telephone | 501-753-4132
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Fax | 501-753-4176
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Provider Business Mailing Address
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Address Line | 212 MAIN ST
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City | MINNEOLA
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State | KS
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Zip | 67865-8511
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Country | US
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Telephone | 620-885-4202
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E-17773
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 04-41285
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License Number State | KS
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