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NPI 1093604001

NPI 1093604001 : MACEY KAY DECKER : LITTLE ROCK, AR

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General NPI Number Information
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    NPI Number           |    1093604001
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    Entity Type          |    Individual 
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    Provider Name        |    MACEY KAY DECKER
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/02/2025
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    Last Update Date     |    10/23/2025
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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 DR STE LL100 
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    City                 |    NORTH LITTLE ROCK
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    State                |    AR
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    Zip                  |    72117-2966
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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    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363AS0400X
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    Taxonomy Name        |    Surgical Physician Assistant
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    363AM0700X
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    Taxonomy Name        |    Medical Physician Assistant
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    
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    License Number State |    
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