Healthcare Provider Details

I. General information

NPI: 1871521005
Provider Name (Legal Business Name): RICHARD J RAPP M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 04/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10001 LILE DR
LITTLE ROCK AR
72205-6217
US

IV. Provider business mailing address

10001 LILE DR
LITTLE ROCK AR
72205-6217
US

V. Phone/Fax

Practice location:
  • Phone: 501-227-8000
  • Fax: 501-221-5850
Mailing address:
  • Phone: 501-227-8000
  • Fax: 501-604-8713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberR3825
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: