Healthcare Provider Details

I. General information

NPI: 1164491270
Provider Name (Legal Business Name): JAMES DOUGLAS STUDDARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 10/15/2020
Certification Date: 10/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9501 BAPTIST HEALTH DR STE. 800
LITTLE ROCK AR
72205-6225
US

IV. Provider business mailing address

1900 MALVERN AVENUE STE 401
HOT SPRINGS AR
71901
US

V. Phone/Fax

Practice location:
  • Phone: 501-223-2080
  • Fax: 501-223-2088
Mailing address:
  • Phone: 501-623-6455
  • Fax: 501-623-7257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number26911
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberC-4534
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: