Healthcare Provider Details

I. General information

NPI: 1346293974
Provider Name (Legal Business Name): JARROD RODNEY ADKISSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JARROD R. ADKISSON

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 WEST 12TH. STREET
LITTLE ROCK AR
72204-1511
US

IV. Provider business mailing address

P.O. BOX 251970
LITTLE ROCK AR
72225-1970
US

V. Phone/Fax

Practice location:
  • Phone: 501-666-8686
  • Fax: 501-660-6832
Mailing address:
  • Phone: 501-666-8686
  • Fax: 501-660-6830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC-8412
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberC-8412
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: