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General NPI Number Information
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NPI Number | 1700178746
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Entity Type | Individual
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Provider Name | RICHARD DAVID BETZOLD M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/10/2011
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Last Update Date | 06/24/2024
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Provider Practice Location Address
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Address Line | 4301 W MARKHAM ST # 556
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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 | 501-686-8000
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Fax | 501-686-5148
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Provider Business Mailing Address
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Address Line | 4301 W MARKHAM ST # 783
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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 | 501-686-8000
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Fax | 501-526-5148
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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 | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | E-8101
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | E-8101
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 56040
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 43363
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License Number State | AL
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Taxonomy #5
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | D86205
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License Number State | MD
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Taxonomy #6
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | D86205
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License Number State | MD
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