Healthcare Provider Details

I. General information

NPI: 1932307394
Provider Name (Legal Business Name): DAVID T STROUD RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 BROOKWOOD DR
LITTLE ROCK AR
72202-1734
US

IV. Provider business mailing address

1500 OAKWOOD CIR
WHITE HALL AR
71602-9675
US

V. Phone/Fax

Practice location:
  • Phone: 501-296-3311
  • Fax: 501-296-3310
Mailing address:
  • Phone: 870-692-2373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6342
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: