Healthcare Provider Details
I. General information
NPI: 1861817298
Provider Name (Legal Business Name): EPOCH HEALTH- LITTLE ROCK, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/21/2014
Last Update Date: 02/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
801 S. BOWMAN ROAD SUITE 3
LITTLE ROCK AR
72211
US
IV. Provider business mailing address
PO BOX 479
BRYANT AR
72089-0479
US
V. Phone/Fax
- Phone: 501-945-0680
- Fax: 501-945-4179
- Phone: 501-246-3423
- Fax: 501-613-0888
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ADAM
J
COLE
Title or Position: AUTHORIZED OFFICIAL & OWNER
Credential: MD
Phone: 318-834-5225