Healthcare Provider Details

I. General information

NPI: 1649192923
Provider Name (Legal Business Name): PHILLIP TAYLOR BURGESS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 CENTER ST
LITTLE ROCK AR
72201-4402
US

IV. Provider business mailing address

111 CENTER ST
LITTLE ROCK AR
72201-4402
US

V. Phone/Fax

Practice location:
  • Phone: 501-377-3443
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD12352
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: