Healthcare Provider Details
I. General information
NPI: 1336331057
Provider Name (Legal Business Name): HAROLD H. CHAKALES, M. D., P. A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/16/2007
Last Update Date: 08/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5 SAINT VINCENT CIR SUITE 300
LITTLE ROCK AR
72205-5412
US
IV. Provider business mailing address
5 SAINT VINCENT CIR SUITE 300
LITTLE ROCK AR
72205-5412
US
V. Phone/Fax
- Phone: 501-664-1500
- Fax: 501-664-8529
- Phone: 501-664-1500
- Fax: 501-664-8529
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 302F00000X |
| Taxonomy | Exclusive Provider Organization |
| License Number | R1749 |
| License Number State | AR |
VIII. Authorized Official
Name: MS.
BRIDGET
M
PRESSLEY
Title or Position: OFFICE MANAGER
Credential:
Phone: 501-664-1500