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General NPI Number Information
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NPI Number | 1447711692
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Entity Type | Individual
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Provider Name | ETHAN DANIEL ATWOOD MD
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Gender | Male
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Dates
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Enumeration Date | 03/29/2019
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 400 W CAPITOL AVE STE 1700
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City | LITTLE ROCK
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State | AR
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Zip | 72201-3438
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Country | US
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Telephone | 833-351-8255
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 24449
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City | NEW YORK
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State | NY
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Zip | 10087-0589
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Country | US
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Telephone | 833-351-8255
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | TPME8001
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 42045
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | E-17851
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License Number State | AR
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