MEDICARE: PHILLIP R ALSTON MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760557714
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHILLIP R ALSTON MD PA

Provider Business Mailing Address
First Line	:	3343 SPRINGHILL DR
Second Line	:	STE 1005
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72117-2930
Country	:	US
Telephone Number	:	501-758-9251
Fax Number	:	501-758-0308

Provider Business Practice Location Address
First Line	:	3343 SPRINGHILL DR
Second Line	:	STE 1005
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72117-2930
Country	:	US
Telephone Number	:	501-758-9251
Fax Number	:	501-758-0308

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PHILLIP RAY ALSTON
Credential	:	MD
Telephone Number	:	501-752-9251

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	01/04/2011

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Directions to “PHILLIP R ALSTON MD PA ” Practice Location

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