Healthcare Provider Details

I. General information

NPI: 1568586196
Provider Name (Legal Business Name): ROBERT S MCDONALD R MR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2019 E RACE AVE
SEARCY AR
72143-4725
US

IV. Provider business mailing address

13529 COLONEL GLENN RD
LITTLE ROCK AR
72210-2326
US

V. Phone/Fax

Practice location:
  • Phone: 501-223-0102
  • Fax:
Mailing address:
  • Phone: 501-223-0102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License NumberRT1380
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code2471M1202X
TaxonomyMagnetic Resonance Imaging Radiologic Technologist
License Number290764
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: