Healthcare Provider Details

I. General information

NPI: 1336100262
Provider Name (Legal Business Name): LAWRENCE CURTIS BANDY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 07/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

9601 LILE DR STE 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 NumberE3446
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: