Healthcare Provider Details

I. General information

NPI: 1699781450
Provider Name (Legal Business Name): ELEANOR ANN LIPSMEYER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 W MARKHAM ST SLOT 509
LITTLE ROCK AR
72205-7101
US

IV. Provider business mailing address

4301 W MARKHAM ST SLOT 509
LITTLE ROCK AR
72205-7101
US

V. Phone/Fax

Practice location:
  • Phone: 501-686-5586
  • Fax: 501-603-1380
Mailing address:
  • Phone: 501-686-5586
  • Fax: 501-603-1380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberC 3112
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: