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NPI Code Detail

MEDICARE: ANDREW ALAN ANTONETTI M.D.

MEDICARE:   ANDREW ALAN ANTONETTI  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1447010012
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW ALAN ANTONETTI M.D.
Provider Business Mailing Address
First Line : 7301 ROGERS AVE
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-4100
Country : US
Telephone Number : 479-314-6000
Fax Number : 479-314-4705
Provider Business Practice Location Address
First Line : 7301 ROGERS AVE
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-4100
Country : US
Telephone Number : 479-314-6000
Fax Number : 479-314-4705
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2024
Last Update Date : 05/29/2026

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Directions to “ ANDREW ALAN ANTONETTI M.D.” Practice Location

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