Basic Information
Provider Information
NPI: 1467762997
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PALOT MANZIL
FirstName: FATHIMA
MiddleName: FIJULA
NamePrefix:  
NameSuffix:  
Credential: M.B.B.S.
OtherOrganizationName:  
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Mailing Information
Address1: 4301 W MARKHAM ST # 783
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722057101
CountryCode: US
TelephoneNumber: 5016868000
FaxNumber: 5015265148
Practice Location
Address1: 4301 W MARKHAM ST # 556
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722057101
CountryCode: US
TelephoneNumber: 5016866661
FaxNumber: 5015266525
Other Information
ProviderEnumerationDate: 10/18/2010
LastUpdateDate: 07/31/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/31/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207U00000XE-12123ARY Allopathic & Osteopathic PhysiciansNuclear Medicine 

No ID Information.


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