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General NPI Number Information
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NPI Number | 1316009731
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Entity Type | Individual
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Provider Name | BARRY F URETSKY MD
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Gender | Male
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 04/28/2009
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Provider Practice Location Address
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Address Line | 4301 MARHAM AVENUE S-304 SHOREY BUILDING
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City | LITTLE ROCK
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State | AR
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Zip | 72205
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Country | US
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Telephone | 501-603-1267
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Fax | 501-257-5796
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Provider Business Mailing Address
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Address Line | 4301 W MARKHAM ST S-304 SHOREY BUILDING
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City | LITTLE ROCK
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State | AR
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Zip | 72205-7101
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Country | US
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Telephone | 501-688-9417
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Fax | 501-257-5796
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | K1155
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | E5214
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License Number State | AR
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