person
David M Street, PA
Surgical Physician Assistant in Benton, Arkansas
NPI 1487252755

David M Street is a Surgical Physician Assistant based in Benton, AR and is specialized in Surgical. David M Street practices in Benton, AR and has the professional credentials of PA. The NPI Number for David M Street is 1487252755 and holds a License No. PT2020058 (Arkansas).

The current practice location address for David M Street is 2010 Active Way, Benton, AR and can be reached out via phone at 501-315-0984 and via fax at 501-847-1405. You can also correspond with David M Street through the mailing address at 2010 ACTIVE WAY, BENTON, AR - 72022-9267 (mailing address contact number: 501-315-0984).

Location: 2010 Active Way, Benton, AR, 72022-9267
person
Provider Profile Details
NPI Number
1487252755
Provider Name
David M Street
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
2010 Active Way, Benton, AR, 72022-9267
Phone Number
501-315-0984
Fax Number
501-847-1405
Provider Enumeration Date
10/09/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
PT2020-058 01 AR ARKANSAS STATE LICENSE
institution
Provider Business Practice Location Address Details
Address
2010 Active Way
City
State
Zip
72022-9267
Phone Number
501-315-0984
Fax Number
501-847-1405
person
Provider Business Mailing Address Details
Address
2010 Active Way
City
State
Zip
72022-9267
Phone Number
501-315-0984
Fax Number
501-847-1405
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
PT2020058 (Arkansas)
Definition
Definition to come...
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