Healthcare Provider Details

I. General information

NPI: 1538164421
Provider Name (Legal Business Name): NURI ILKER AKKUS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5315 WEST 12TH STREET
LITTLE ROCK AR
72204-1858
US

IV. Provider business mailing address

11001 EXECUTIVE CENTER DRIVE SUITE 200
LITTLE ROCK AR
72211-4393
US

V. Phone/Fax

Practice location:
  • Phone: 501-664-0941
  • Fax: 501-666-3956
Mailing address:
  • Phone: 501-812-7215
  • Fax: 501-812-7207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number203943
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number04-38772
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberE-3259
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: