Healthcare Provider Details

I. General information

NPI: 1033351507
Provider Name (Legal Business Name): MEGHAN FREILEY REPP M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2009
Last Update Date: 06/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 SPRINGHILL RD STE 200
BRYANT AR
72019-7566
US

IV. Provider business mailing address

2301 SPRINGHILL RD STE 200
BRYANT AR
72019-7566
US

V. Phone/Fax

Practice location:
  • Phone: 501-847-2500
  • Fax:
Mailing address:
  • Phone: 501-847-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE-7512
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: