Healthcare Provider Details

I. General information

NPI: 1457553869
Provider Name (Legal Business Name): GEORGE SCHROEDER, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 02/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9800 LILE DR STE 301
LITTLE ROCK AR
72205-6230
US

IV. Provider business mailing address

9800 LILE DR STE 301
LITTLE ROCK AR
72205-6230
US

V. Phone/Fax

Practice location:
  • Phone: 501-225-4488
  • Fax: 501-225-9299
Mailing address:
  • Phone: 501-225-4488
  • Fax: 501-225-9299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberR1935
License Number StateAR

VIII. Authorized Official

Name: DR. GEORGE T SCHROEDER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 501-225-4488