Healthcare Provider Details

I. General information

NPI: 1982181608
Provider Name (Legal Business Name): CHI ARTHRITIS & RHEUMATOLOGY ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2018
Last Update Date: 02/17/2021
Certification Date: 02/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 SHACKLEFORD DR
LITTLE ROCK AR
72211-2858
US

IV. Provider business mailing address

6 SHACKLEFORD DR
LITTLE ROCK AR
72211-2858
US

V. Phone/Fax

Practice location:
  • Phone: 501-500-5001
  • Fax:
Mailing address:
  • Phone: 501-500-5001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberE-3762
License Number StateAR

VIII. Authorized Official

Name: JASEN C. CHI
Title or Position: SOLE OWNER
Credential: MD
Phone: 501-500-5001