Healthcare Provider Details

I. General information

NPI: 1851381339
Provider Name (Legal Business Name): ERIC C. BURDGE MD, PHD, FACS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 CARTI WAY
LITTLE ROCK AR
72205-6523
US

IV. Provider business mailing address

PO BOX 55050
LITTLE ROCK AR
72215-5050
US

V. Phone/Fax

Practice location:
  • Phone: 501-906-3000
  • Fax: 501-907-8367
Mailing address:
  • Phone: 501-906-3000
  • Fax: 501-907-8367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD00047349
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4301086111
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number225395
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberE-7559
License Number StateAR
# 5
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberMD450250
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: