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General NPI Number Information
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NPI Number | 1285521476
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Entity Type | Individual
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Provider Name | DRAKE DAVID LEE
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Gender | Male
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Dates
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Enumeration Date | 06/20/2025
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 937 HIGHWAY 64 E
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City | ALMA
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State | AR
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Zip | 72921-7382
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Country | US
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Telephone | 479-632-3855
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Fax |
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Provider Business Mailing Address
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Address Line | 11001 EXECUTIVE CENTER DR STE 200
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City | LITTLE ROCK
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State | AR
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Zip | 72211-4393
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Country | US
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Telephone | 479-632-3855
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Fax | 479-632-0356
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 123498
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License Number State | AR
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