Healthcare Provider Details

I. General information

NPI: 1750410999
Provider Name (Legal Business Name): ADIL IMRAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 06/18/2021
Certification Date: 06/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 WEST 10TH STREET SUITE 610
LITTLE ROCK AR
72204
US

IV. Provider business mailing address

5800 WEST 10TH STREET SUITE 610
LITTLE ROCK AR
72204
US

V. Phone/Fax

Practice location:
  • Phone: 501-661-9393
  • Fax: 501-663-4795
Mailing address:
  • Phone: 501-661-9393
  • Fax: 501-663-4795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberE-5061
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberE5061
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberE5061
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: