Healthcare Provider Details

I. General information

NPI: 1053423350
Provider Name (Legal Business Name): SAFWAN H SAKR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 04/17/2019
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:
Mailing address:
  • Phone: 501-227-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberE2130
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: