Healthcare Provider Details

I. General information

NPI: 1558321612
Provider Name (Legal Business Name): COLUMBUS BROWN IV M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S UNIVERSITY AVE STE 815
LITTLE ROCK AR
72205-5310
US

IV. Provider business mailing address

500 S UNIVERSITY AVE STE 815
LITTLE ROCK AR
72205-5310
US

V. Phone/Fax

Practice location:
  • Phone: 501-747-1064
  • Fax:
Mailing address:
  • Phone: 501-747-1064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberE2743
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: