Healthcare Provider Details

I. General information

NPI: 1477535391
Provider Name (Legal Business Name): LITTLE ROCK HEMATOLOGY ONCOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 05/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 BAPTIST HEALTH DR
LITTLE ROCK AR
72205-6319
US

IV. Provider business mailing address

9500 BAPTIST HEALTH DR
LITTLE ROCK AR
72205-6319
US

V. Phone/Fax

Practice location:
  • Phone: 501-219-8777
  • Fax: 501-907-6522
Mailing address:
  • Phone: 501-219-8777
  • Fax: 501-907-6522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. SYLVIA MURCHISON
Title or Position: ADMINISTRATOR
Credential: C.P.A., M.B.A.
Phone: 501-219-8777