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General NPI Number Information
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NPI Number | 1013930320
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Entity Type | Organization
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Legal Business Name | ARKANSAS DERMATOLOGY PLLC
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 9601 BAPTIST HEALTH DR STE 860
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City | LITTLE ROCK
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State | AR
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Zip | 72205-6375
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Country | US
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Telephone | 501-975-7455
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Fax | 501-975-3631
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Provider Business Mailing Address
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Address Line | 4261 STOCKTON DRIVE SUITE LL100
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72117
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Country | US
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Telephone | 501-975-7456
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Fax | 501-978-1822
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | KEMMERLY DRAKE THOMAS
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Credential |
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Telephone | 501-515-8136
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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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