Healthcare Provider Details
I. General information
NPI: 1134338130
Provider Name (Legal Business Name): NORMAN R PLEDGER MD PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5207 E BROADWAY ST
NORTH LITTLE ROCK AR
72117-4029
US
IV. Provider business mailing address
5207 E BROADWAY ST
NORTH LITTLE ROCK AR
72117-4029
US
V. Phone/Fax
- Phone: 501-945-2033
- Fax: 501-945-2303
- Phone: 501-945-2033
- Fax: 501-945-2303
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | R2917 |
| License Number State | AR |
VIII. Authorized Official
Name:
DONNA
P
NORWOOD
Title or Position: OFFICE MGR
Credential:
Phone: 501-945-2033