Healthcare Provider Details
I. General information
NPI: 1750753224
Provider Name (Legal Business Name): ERICK MESSIAS MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/23/2015
Last Update Date: 10/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2723 FOXCROFT RD SUITE 311A
LITTLE ROCK AR
72227-2455
US
IV. Provider business mailing address
14 RIDGEVIEW CT
LITTLE ROCK AR
72227-2360
US
V. Phone/Fax
- Phone: 501-773-9439
- Fax: 877-726-1180
- Phone: 501-773-9439
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084B0040X |
| Taxonomy | Behavioral Neurology & Neuropsychiatry Physician |
| License Number | E-6367 |
| License Number State | AR |
VIII. Authorized Official
Name: DR.
ERICK
MESSIAS
Title or Position: OWNER
Credential: MD
Phone: 501-773-9439