Healthcare Provider Details

I. General information

NPI: 1639362593
Provider Name (Legal Business Name): HAROLD H. CHAKALES, M. D., P. A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2007
Last Update Date: 04/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 SAINT VINCENT CIR STE 300
LITTLE ROCK AR
72205-5417
US

IV. Provider business mailing address

5 SAINT VINCENT CIR STE 300
LITTLE ROCK AR
72205-5417
US

V. Phone/Fax

Practice location:
  • Phone: 501-664-1500
  • Fax: 501-664-8529
Mailing address:
  • Phone: 501-664-1500
  • Fax: 501-664-8529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberR1749
License Number StateAR

VIII. Authorized Official

Name: MRS. BRIDGET MARIE HART
Title or Position: OFFICE MANAGER
Credential:
Phone: 501-664-1500