Healthcare Provider Details

I. General information

NPI: 1003532276
Provider Name (Legal Business Name): ORLANDO ANDERSON MLS (ASCP)
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2022
Last Update Date: 10/18/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 W 7TH ST
LITTLE ROCK AR
72205-5446
US

IV. Provider business mailing address

1008 REGAL DR
NORTH LITTLE ROCK AR
72118-2642
US

V. Phone/Fax

Practice location:
  • Phone: 501-257-1000
  • Fax:
Mailing address:
  • Phone: 501-310-1322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246QB0000X
TaxonomyBlood Banking Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246QC1000X
TaxonomyChemistry Pathology Specialist/Technologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code246QH0000X
TaxonomyHematology Specialist/Technologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code246QI0000X
TaxonomyImmunology Pathology Specialist/Technologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code246QM0900X
TaxonomyMicrobiology Specialist/Technologist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code246RM2200X
TaxonomyMedical Laboratory Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: