Healthcare Provider Details

I. General information

NPI: 1417973926
Provider Name (Legal Business Name): ROBERT TODD MAXSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS WAY # 653
LITTLE ROCK AR
72202-3500
US

IV. Provider business mailing address

1 CHILDRENS WAY # 653
LITTLE ROCK AR
72202-3500
US

V. Phone/Fax

Practice location:
  • Phone: 501-364-1100
  • Fax: 501-364-4082
Mailing address:
  • Phone: 501-364-1100
  • Fax: 501-364-4082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC-8200
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberK5152
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberC-8200
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: