Healthcare Provider Details

I. General information

NPI: 1427104025
Provider Name (Legal Business Name): GUILLERMO ALEJANDRO ESCOBAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: GUILLERMO CURN ESCOBAR MD

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 08/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 W MARKHAM ST # 783
LITTLE ROCK AR
72205-7101
US

IV. Provider business mailing address

4301 W MARKHAM ST SLOT 520-2
LITTLE ROCK AR
72205-7101
US

V. Phone/Fax

Practice location:
  • Phone: 501-686-8000
  • Fax: 501-526-6562
Mailing address:
  • Phone: 501-686-5328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4301092987
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number4301092987
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberDR-43891
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberE-8153
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: