Healthcare Provider Details

I. General information

NPI: 1487888236
Provider Name (Legal Business Name): CENTRAL ARKANSAS CLINIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2009
Last Update Date: 05/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S UNIVERSITY AVE STE 305
LITTLE ROCK AR
72205-5342
US

IV. Provider business mailing address

PO BOX 7838
TEXARKANA TX
75505-7838
US

V. Phone/Fax

Practice location:
  • Phone: 501-372-7246
  • Fax: 501-324-1518
Mailing address:
  • Phone: 501-372-7246
  • Fax: 501-324-1518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT B REICHARD JR.
Title or Position: OWNER
Credential: MD
Phone: 501-372-7246