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General NPI Number Information
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NPI Number | 1215679162
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Entity Type | Individual
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Provider Name | YAMA N FAZLI MD
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Gender | Male
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Dates
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Enumeration Date | 04/11/2022
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 1 CHILDRENS WAY
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City | LITTLE ROCK
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State | AR
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Zip | 72202-3500
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Country | US
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Telephone | 501-441-3453
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Fax |
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Provider Business Mailing Address
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Address Line | 3400 S BOWMAN RD APT 210
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City | LITTLE ROCK
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State | AR
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Zip | 72211-4636
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Country | US
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Telephone | 310-936-5404
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | E-19473
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License Number State | AR
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