Healthcare Provider Details

I. General information

NPI: 1659387181
Provider Name (Legal Business Name): EDWARD L PILLOW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 SHIRLEY HICKS DR
HELENA AR
72342-8852
US

IV. Provider business mailing address

101 SHIRLEY HICKS DR
HELENA AR
72342-8852
US

V. Phone/Fax

Practice location:
  • Phone: 870-572-5996
  • Fax: 870-572-4471
Mailing address:
  • Phone: 870-572-5996
  • Fax: 870-572-4471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE4870
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberE4870
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: