Provider Demographics
NPI:1316155914
Name:ALSAEK, YASER (MD)
Entity type:Individual
Prefix:
First Name:YASER
Middle Name:
Last Name:ALSAEK
Suffix:
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 1:228 W TYLER AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-4089
Mailing Address - Country:US
Mailing Address - Phone:870-733-5437
Mailing Address - Fax:870-733-5440
Practice Address - Street 1:228 W TYLER AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-4089
Practice Address - Country:US
Practice Address - Phone:870-733-5437
Practice Address - Fax:870-733-5440
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44151208000000X
ARE-5692208000000X
KYTP188208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5H319OtherBCBS AR
AR172722001Medicaid
7007074OtherCIGNA
AR172722001Medicaid