Healthcare Provider Details

I. General information

NPI: 1427577089
Provider Name (Legal Business Name): FABIOLA DEL CARMEN OBREGON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FABIOLA DEL CARMEN ESCOBAR

II. Dates (important events)

Enumeration Date: 09/14/2017
Last Update Date: 10/03/2022
Certification Date: 10/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 WILSON RD
LITTLE ROCK AR
72205-6659
US

IV. Provider business mailing address

1301 WILSON RD
LITTLE ROCK AR
72205-6659
US

V. Phone/Fax

Practice location:
  • Phone: 501-225-0576
  • Fax: 501-225-6789
Mailing address:
  • Phone: 501-225-0576
  • Fax: 501-225-6789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberE15548
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: