Healthcare Provider Details

I. General information

NPI: 1043386139
Provider Name (Legal Business Name): JAMES D STUDDARD, MD, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 07/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 AUTUMN RD STE 500
LITTLE ROCK AR
72211-3738
US

IV. Provider business mailing address

904 AUTUMN RD STE 500
LITTLE ROCK AR
72211-3738
US

V. Phone/Fax

Practice location:
  • Phone: 501-225-9905
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberC4534
License Number StateAR

VIII. Authorized Official

Name: DR. JAMES D STUDDARD
Title or Position: OWNER
Credential: M.D.
Phone: 501-225-9905