Provider Demographics
NPI:1285053983
Name:MONTIEL, PATRICIO JOSE II (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIO
Middle Name:JOSE
Last Name:MONTIEL
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7003 CHAD COLLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:BARLING
Mailing Address - State:AR
Mailing Address - Zip Code:72923-3000
Mailing Address - Country:US
Mailing Address - Phone:479-431-3500
Mailing Address - Fax:
Practice Address - Street 1:7003 CHAD COLLEY BLVD
Practice Address - Street 2:
Practice Address - City:BARLING
Practice Address - State:AR
Practice Address - Zip Code:72923-3000
Practice Address - Country:US
Practice Address - Phone:479-431-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-9971207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR218637001Medicaid