Healthcare Provider Details

I. General information

NPI: 1104320993
Provider Name (Legal Business Name): CASIE MARIE JAMES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2018
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 GENE GEORGE BLVD
SPRINGDALE AR
72762-0845
US

IV. Provider business mailing address

PO BOX 251418
LITTLE ROCK AR
72225-1418
US

V. Phone/Fax

Practice location:
  • Phone: 479-725-6866
  • Fax: 479-725-6868
Mailing address:
  • Phone: 501-364-1100
  • Fax: 501-364-4082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE-16680
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: