Healthcare Provider Details

I. General information

NPI: 1427287887
Provider Name (Legal Business Name): AMY LYNN BEARD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMY LYNN GARRISON M.D.

II. Dates (important events)

Enumeration Date: 07/07/2009
Last Update Date: 03/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 CLUB MANOR DR SUITE J2
MAUMELLE AR
72113-7411
US

IV. Provider business mailing address

6917 SKYWOOD RD
LITTLE ROCK AR
72207-1744
US

V. Phone/Fax

Practice location:
  • Phone: 501-581-1212
  • Fax:
Mailing address:
  • Phone: 501-350-3433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberE-6836
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE-6836
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: