Healthcare Provider Details

I. General information

NPI: 1184793259
Provider Name (Legal Business Name): ANIKA T WHITFIELD DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 12/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 SOUTH UNIVERSITY SUITE 707
LITTLE ROCK AR
72205
US

IV. Provider business mailing address

500 SOUTH UNIVERSITY SUITE 707
LITTLE ROCK AR
72205
US

V. Phone/Fax

Practice location:
  • Phone: 501-614-7800
  • Fax: 501-660-7835
Mailing address:
  • Phone: 501-614-7800
  • Fax: 501-660-7835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number225
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number225
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: