Healthcare Provider Details

I. General information

NPI: 1306069661
Provider Name (Legal Business Name): ARKANSAS GYN ONCOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 04/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 LILE DR SUITE 850
LITTLE ROCK AR
72205-6321
US

IV. Provider business mailing address

9601 LILE DR SUITE 850
LITTLE ROCK AR
72205-6321
US

V. Phone/Fax

Practice location:
  • Phone: 501-221-3088
  • Fax: 501-221-0072
Mailing address:
  • Phone: 501-221-3088
  • Fax: 501-221-0072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: LAWRENCE CURTIS BANDY
Title or Position: DOCTOR
Credential: M.D.
Phone: 501-221-3088