Healthcare Provider Details

I. General information

NPI: 1174586986
Provider Name (Legal Business Name): JULI MCCALL R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SAINT VINCENT CIR SUITE 210
LITTLE ROCK AR
72205-5405
US

IV. Provider business mailing address

650 S SHACKLEFORD RD SUITE 439
LITTLE ROCK AR
72211-3527
US

V. Phone/Fax

Practice location:
  • Phone: 501-552-4777
  • Fax: 501-552-4570
Mailing address:
  • Phone: 501-224-1690
  • Fax: 501-224-1927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number932
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: