Healthcare Provider Details

I. General information

NPI: 1942736285
Provider Name (Legal Business Name): BP ANESTHESIA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2017
Last Update Date: 05/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 ARKANSAS VALLEY DR SUITE 202
LITTLE ROCK AR
72212-4166
US

IV. Provider business mailing address

3603 ROBINWOOD CIR
BRYANT AR
72022-8375
US

V. Phone/Fax

Practice location:
  • Phone: 501-227-0700
  • Fax: 501-227-0744
Mailing address:
  • Phone: 501-593-5223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberC002931
License Number StateAR

VIII. Authorized Official

Name: BRADLEY A PITTS
Title or Position: OWNER
Credential: CRNA
Phone: 501-593-5223