Type 1 individualNPI 1003371709
STAR HARBOTTLE LAC
101YM0800X · FORT SMITH, AR
Why this profile is appearing now
Observed change signals
No current public change signal is attached to this profile.
Reported classification
Taxonomies
| Code | Description | Source flag |
|---|---|---|
| 101YM0800X | 101YM0800X | Primary |
| 171M00000X | 171M00000X | Additional |
Taxonomy reporting does not establish licensure, board certification, expertise, or quality.
Longitudinal record
Observed change timeline
- 0 recorded field change s