Healthcare Provider Details

I. General information

NPI: 1790980837
Provider Name (Legal Business Name): ROSALYN KEANI ENOS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5328 NORTHSHORE CV STE 1A
NORTH LITTLE ROCK AR
72118-5332
US

IV. Provider business mailing address

PO BOX 15730
LITTLE ROCK AR
72231-5730
US

V. Phone/Fax

Practice location:
  • Phone: 501-225-1400
  • Fax: 501-225-1401
Mailing address:
  • Phone: 501-225-1400
  • Fax: 501-225-1401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number4568
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberE-15348
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: