Healthcare Provider Details

I. General information

NPI: 1003642166
Provider Name (Legal Business Name): PINNACLE GASTROENTEROLOGY ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2024
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 N UNIVERSITY AVE
LITTLE ROCK AR
72205-3108
US

IV. Provider business mailing address

409 N UNIVERSITY AVE
LITTLE ROCK AR
72205-3108
US

V. Phone/Fax

Practice location:
  • Phone: 501-246-4561
  • Fax: 501-246-4636
Mailing address:
  • Phone: 501-246-4561
  • Fax: 501-246-4636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARION YORK
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 501-246-4561