Healthcare Provider Details

I. General information

NPI: 1376577387
Provider Name (Legal Business Name): EYAD ABOCHALE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 08/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 BAPTIST HEALTH DRIVE MED TOWER 1 SUITE 970
LITTLE ROCK AR
72205
US

IV. Provider business mailing address

11001 EXECUTIVE CENTER DR STE 200
LITTLE ROCK AR
72211-4393
US

V. Phone/Fax

Practice location:
  • Phone: 501-224-1172
  • Fax: 501-850-0465
Mailing address:
  • Phone: 501-812-7800
  • Fax: 501-812-7777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberE1685
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberE1685
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberE1685
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: