Healthcare Provider Details

I. General information

NPI: 1972131670
Provider Name (Legal Business Name): HEIDI DAWN MEREDITH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2020
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 S SHACKLEFORD RD
LITTLE ROCK AR
72211
US

IV. Provider business mailing address

1901 ENCORE WAY
BRYANT AR
72019-8896
US

V. Phone/Fax

Practice location:
  • Phone: 501-219-7000
  • Fax:
Mailing address:
  • Phone: 501-213-4500
  • Fax: 501-526-5148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberE-15709
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: