Healthcare Provider Details

I. General information

NPI: 1265029250
Provider Name (Legal Business Name): ROBBIE R ATKINSON, DDS, MD, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2020
Last Update Date: 12/24/2020
Certification Date: 12/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 W 40TH AVE STE 2A
PINE BLUFF AR
71603-6957
US

IV. Provider business mailing address

1801 W 40TH AVE STE 2A
PINE BLUFF AR
71603-6957
US

V. Phone/Fax

Practice location:
  • Phone: 870-536-9609
  • Fax: 870-534-5327
Mailing address:
  • Phone: 870-536-9609
  • Fax: 870-534-5327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LIQUINTA PIPES
Title or Position: OFFICE MANAGER
Credential:
Phone: 870-550-4934