Healthcare Provider Details

I. General information

NPI: 1194255349
Provider Name (Legal Business Name): RIVER NORTH PODIATRY, P. A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2017
Last Update Date: 06/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2411 MCCAIN BLVD
NORTH LITTLE ROCK AR
72116-7505
US

IV. Provider business mailing address

2411 MCCAIN BLVD
NORTH LITTLE ROCK AR
72116-7505
US

V. Phone/Fax

Practice location:
  • Phone: 501-680-5379
  • Fax:
Mailing address:
  • Phone: 501-690-5379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. JAME BETH PIERCE
Title or Position: PODIATRIST
Credential: DPM
Phone: 501-680-5379