Healthcare Provider Details

I. General information

NPI: 1336272913
Provider Name (Legal Business Name): JOSE ANTONIO ALBISU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 N UNIVERSITY AVE
LITTLE ROCK AR
72205-3108
US

IV. Provider business mailing address

PO BOX 7377
LITTLE ROCK AR
72217-7377
US

V. Phone/Fax

Practice location:
  • Phone: 501-246-4561
  • Fax: 501-246-4636
Mailing address:
  • Phone: 501-246-4561
  • Fax: 501-246-4636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberE-20108
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: