Healthcare Provider Details

I. General information

NPI: 1750377537
Provider Name (Legal Business Name): ROBERT W LAAKMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 09/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S UNIVERSITY AVE SUITE 101
LITTLE ROCK AR
72205-5302
US

IV. Provider business mailing address

500 S UNIVERSITY AVE SUITE 101
LITTLE ROCK AR
72205-5302
US

V. Phone/Fax

Practice location:
  • Phone: 501-664-3914
  • Fax: 501-664-5246
Mailing address:
  • Phone: 501-664-3914
  • Fax: 501-664-5246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberN6957
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: