Healthcare Provider Details

I. General information

NPI: 1710146907
Provider Name (Legal Business Name): J P ROWEN SURGERY, PLC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2008
Last Update Date: 06/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9501 LILE DR STE 888
LITTLE ROCK AR
72205-6233
US

IV. Provider business mailing address

9501 LILE DR STE 888
LITTLE ROCK AR
72205-6233
US

V. Phone/Fax

Practice location:
  • Phone: 501-954-8500
  • Fax: 501-954-8502
Mailing address:
  • Phone: 501-954-8500
  • Fax: 501-954-8502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN PATRICK ROWEN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 501-954-8500