Healthcare Provider Details

I. General information

NPI: 1407590953
Provider Name (Legal Business Name): MATTHEW ADAM RATLIFF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2022
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 E KIEHL AVE
SHERWOOD AR
72120-3040
US

IV. Provider business mailing address

11001 EXECUTIVE CENTER DR STE 200
LITTLE ROCK AR
72211-4393
US

V. Phone/Fax

Practice location:
  • Phone: 501-835-0703
  • Fax: 501-833-1716
Mailing address:
  • Phone: 501-835-0703
  • Fax: 501-833-1716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE19314
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: