Healthcare Provider Details

I. General information

NPI: 1295776045
Provider Name (Legal Business Name): NORMAN R. PLEDGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 02/22/2011
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

Practice location:
  • Phone: 501-945-2033
  • Fax: 501-945-2303
Mailing address:
  • Phone: 501-945-2033
  • Fax: 501-945-2303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR2917
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: