Provider Demographics
NPI:1780175257
Name:VALMONT, IAN JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:IAN
Middle Name:JAMES
Last Name:VALMONT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:IAN
Other - Middle Name:JAMES
Other - Last Name:BILBO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3417 U OF A WAY
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:AR
Mailing Address - Zip Code:71854-1419
Mailing Address - Country:US
Mailing Address - Phone:870-779-6000
Mailing Address - Fax:870-779-6093
Practice Address - Street 1:300 E 6TH ST
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:AR
Practice Address - Zip Code:71854-5207
Practice Address - Country:US
Practice Address - Phone:870-779-6000
Practice Address - Fax:870-779-6093
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-21
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-12587207P00000X
390200000X
TXT6403207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program