Healthcare Provider Details

I. General information

NPI: 1396700829
Provider Name (Legal Business Name): JOE WALTER CROW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 07/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4020 RICHARDS RD
NORTH LITTLE ROCK AR
72117-2650
US

IV. Provider business mailing address

4020 RICHARDS RD
NORTH LITTLE ROCK AR
72117-2650
US

V. Phone/Fax

Practice location:
  • Phone: 501-771-1600
  • Fax: 501-955-2252
Mailing address:
  • Phone: 501-771-1600
  • Fax: 501-955-2252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberC4023
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: