Healthcare Provider Details

I. General information

NPI: 1386797140
Provider Name (Legal Business Name): MARLON JOSEPH DOUCET M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 07/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 W 7TH ST
LITTLE ROCK AR
72205
US

IV. Provider business mailing address

5424 PLANTATION DR
LITTLE ROCK AR
72206-8844
US

V. Phone/Fax

Practice location:
  • Phone: 501-257-5072
  • Fax:
Mailing address:
  • Phone: 501-258-6894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberR-3515
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR-3515
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: