1578944385 NPI number — FOOT & ANKLE ASSOCIATES OF CENTRAL ARKANSAS, PLLC

Table of content: (NPI 1578944385)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578944385 NPI number — FOOT & ANKLE ASSOCIATES OF CENTRAL ARKANSAS, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOOT & ANKLE ASSOCIATES OF CENTRAL ARKANSAS, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
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Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
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Provider Other Last Name:
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NPI Number Information

NPI Number:
1578944385
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4200 N RODNEY PARHAM RD
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
LITTLE ROCK
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72212-2461
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-534-8888
Provider Business Mailing Address Fax Number:
501-534-8891

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1900 MALVERN AVE
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
HOT SPRINGS
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
71901-7759
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-321-2444
Provider Business Practice Location Address Fax Number:
501-321-9521
Provider Enumeration Date:
06/17/2015

Additional Information

Authorized Official

Authorized Official Last Name:
DELLINGER
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
ALEX
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
501-534-8888

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  167 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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