Healthcare Provider Details

I. General information

NPI: 1669987012
Provider Name (Legal Business Name): DANIEL DAVID RING PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2017
Last Update Date: 04/15/2022
Certification Date: 04/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 WESTPORT DR STE 1
CABOT AR
72023-3657
US

IV. Provider business mailing address

11001 EXECUTIVE CENTER DR STE 200
LITTLE ROCK AR
72211-4393
US

V. Phone/Fax

Practice location:
  • Phone: 501-843-6585
  • Fax: 501-843-2380
Mailing address:
  • Phone: 501-843-6585
  • Fax: 501-843-2380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA-762
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: