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General NPI Number Information
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NPI Number | 1013421536
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY CARE OF ARKANSAS, PLLC
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Dates
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Enumeration Date | 11/20/2017
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Last Update Date | 11/20/2017
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Provider Practice Location Address
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Address Line | 9601 BAPTIST HEALTH DR STE 690
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City | LITTLE ROCK
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State | AR
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Zip | 72205-6328
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Country | US
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Telephone | 501-227-8422
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Fax |
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Provider Business Mailing Address
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Address Line | 9601 BAPTIST HEALTH DR STE 690
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City | LITTLE ROCK
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State | AR
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Zip | 72205-6328
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLING/CREDENTIALING MANAGER
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Name | DEBBIE ULMER
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Credential |
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Telephone | 501-227-8422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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