MEDICARE: DR. REID ALLEN COUNCE MD

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	207R00000X	Internal Medicine Physician	E18148	AR
2	208000000X	Pediatrics Physician	E-18148	AR

General Provider Information

NPI Number	:	1871172544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REID ALLEN COUNCE MD

Provider Business Mailing Address
First Line	:	11001 EXECUTIVE CENTER DR STE 200
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72211-4393
Country	:	US
Telephone Number	:	870-946-0300
Fax Number	:	870-946-0303

Provider Business Practice Location Address
First Line	:	1703 S WHITEHEAD DR
Second Line	:
City	:	DE WITT
State	:	AR
Zip	:	72042-2911
Country	:	US
Telephone Number	:	870-673-7211
Fax Number	:	870-946-0303

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2021
Last Update Date	:	04/09/2026

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