Healthcare Provider Details

I. General information

NPI: 1336493212
Provider Name (Legal Business Name): ADIL IMRAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2012
Last Update Date: 10/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 GLASGOW CT
LITTLE ROCK AR
72211-2169
US

IV. Provider business mailing address

35 GLASGOW CT
LITTLE ROCK AR
72211-2169
US

V. Phone/Fax

Practice location:
  • Phone: 520-204-1746
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberE5061
License Number StateAR

VIII. Authorized Official

Name: DR. ADIL IMRAN
Title or Position: OWNER
Credential:
Phone: 520-245-9085