Healthcare Provider Details

I. General information

NPI: 1639390701
Provider Name (Legal Business Name): JESSICA PILLOW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 BAPTIST HEALTH DR STE 690
LITTLE ROCK AR
72205-6328
US

IV. Provider business mailing address

9601 BAPTIST HEALTH DR STE 690
LITTLE ROCK AR
72205-6328
US

V. Phone/Fax

Practice location:
  • Phone: 501-227-8422
  • Fax: 501-537-2399
Mailing address:
  • Phone: 501-227-8422
  • Fax: 501-537-2399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207NI0002X
TaxonomyClinical & Laboratory Dermatological Immunology Physician
License NumberE5188
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code207NP0225X
TaxonomyPediatric Dermatology Physician
License NumberE5188
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberE-5188
License Number StateAR
# 4
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberE-5188
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: