Healthcare Provider Details

I. General information

NPI: 1881809184
Provider Name (Legal Business Name): AMANDA IRENE HOLLINGSWORTH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS WAY 653
LITTLE ROCK AR
72202-3500
US

IV. Provider business mailing address

1935 MEDICAL DISTRICT DR E2.03
DALLAS TX
75235-7701
US

V. Phone/Fax

Practice location:
  • Phone: 501-364-1100
  • Fax: 501-526-6562
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE-8105
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberE-8105
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: