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NPI Code Detail

MEDICARE: ALAN ROBERT STOREYGARD MD

MEDICARE: ALAN ROBERT STOREYGARD 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
1207Q00000XFamily Medicine PhysicianN6020AR

Other Identifiers

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

General Provider Information

NPI Number : 1881690477
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALAN ROBERT STOREYGARD 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 : 501-753-4132
Fax Number : 501-753-4176
Provider Business Practice Location Address
First Line : 3201 SPRINGHILL DR STE 300
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72117-2909
Country : US
Telephone Number : 501-753-4132
Fax Number : 501-753-4176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 01/19/2022

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