Healthcare Provider Details

I. General information

NPI: 1083097349
Provider Name (Legal Business Name): RENEE PETERKIN-MCCALMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RENEE PETERKIN

II. Dates (important events)

Enumeration Date: 07/06/2015
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9101 KANIS RD STE 200
LITTLE ROCK AR
72205-6455
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 501-224-6366
  • Fax: 501-725-8445
Mailing address:
  • Phone: 501-224-6366
  • Fax: 501-725-8445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberE-19617
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberE-19617
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: