Healthcare Provider Details

I. General information

NPI: 1285648360
Provider Name (Legal Business Name): IRVING KUO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 FORT ROOTS DR BUILDING 170, UNIT 1L
NORTH LITTLE ROCK AR
72114-1709
US

IV. Provider business mailing address

2200 FORT ROOTS DR BUILDING 170, UNIT 1L
NORTH LITTLE ROCK AR
72114-1709
US

V. Phone/Fax

Practice location:
  • Phone: 501-257-3131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberN6548
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: