Healthcare Provider Details

I. General information

NPI: 1215947825
Provider Name (Legal Business Name): PULMONARY ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5810 W 10TH ST FREEWAY MEDICAL CENTER STE 610
LITTLE ROCK AR
72204
US

IV. Provider business mailing address

5810 W 10TH ST FREEWAY MEDICAL CENTER STE 610
LITTLE ROCK AR
72204
US

V. Phone/Fax

Practice location:
  • Phone: 501-661-9393
  • Fax: 501-663-4795
Mailing address:
  • Phone: 501-661-9393
  • Fax: 501-663-4795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number StateAR

VIII. Authorized Official

Name: ANTHONY R GIGLIA
Title or Position: PRESIDENT
Credential: MD
Phone: 501-661-9393