Healthcare Provider Details

I. General information

NPI: 1568780575
Provider Name (Legal Business Name): ALICIA MARIE SCHNEBELEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2010
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 TALLEY RD STE 300
LITTLE ROCK AR
72204-8040
US

IV. Provider business mailing address

5100 TALLEY RD STE 300
LITTLE ROCK AR
72204-8040
US

V. Phone/Fax

Practice location:
  • Phone: 501-500-6640
  • Fax:
Mailing address:
  • Phone: 501-500-6640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License NumberQ3958
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberQ3958
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: