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General NPI Number Information
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NPI Number | 1629008487
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Entity Type | Organization
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Legal Business Name | RIVER CITY DERMATOLOGY, P.A.
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 500 S UNIVERSITY AVE SUITE 716
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City | LITTLE ROCK
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State | AR
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Zip | 72205-5302
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Country | US
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Telephone | 501-228-4664
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Fax | 501-228-0011
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Provider Business Mailing Address
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Address Line | 500 S UNIVERSITY AVE SUITE 716
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City | LITTLE ROCK
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State | AR
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Zip | 72205-5302
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Country | US
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Telephone | 501-228-4664
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Fax | 501-228-0011
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JERRI HOSKYN
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Credential | M.D.
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Telephone | 501-228-4664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MC2487
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License Number State | AR
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