Healthcare Provider Details

I. General information

NPI: 1760051007
Provider Name (Legal Business Name): SAMUEL PARRISH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 BAPTIST HEALTH DR
LITTLE ROCK AR
72205-6316
US

IV. Provider business mailing address

14 RIDGETON CT
LITTLE ROCK AR
72211-5442
US

V. Phone/Fax

Practice location:
  • Phone: 501-202-2000
  • Fax:
Mailing address:
  • Phone: 601-927-7419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberE-20258
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: