Healthcare Provider Details

I. General information

NPI: 1730491960
Provider Name (Legal Business Name): ASHOK AKULA M.D.,
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2010
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 W 40TH AVE STE 403
PINE BLUFF AR
71603-6365
US

IV. Provider business mailing address

1600 W 40TH AVE
PINE BLUFF AR
71603-6301
US

V. Phone/Fax

Practice location:
  • Phone: 870-541-4285
  • Fax: 870-541-4290
Mailing address:
  • Phone: 870-541-7100
  • Fax: 870-541-4297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberE20567
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.130209
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number29879
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number69331
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: