Provider Demographics
NPI:1255578894
Name:ALINA MIELNICK, MD, PA
Entity type:Organization
Organization Name:ALINA MIELNICK, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIELNICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:479-394-1861
Mailing Address - Street 1:601 BD HIGHWAY 71 NORTH
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-4394
Mailing Address - Country:US
Mailing Address - Phone:479-394-1861
Mailing Address - Fax:479-394-1322
Practice Address - Street 1:601 BD HIGHWAY 71 NORTH
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-4394
Practice Address - Country:US
Practice Address - Phone:479-394-1861
Practice Address - Fax:479-394-1322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-20
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR4110208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty