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General NPI Number Information
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NPI Number | 1750072708
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Entity Type | Individual
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Provider Name | DOUG NEAL REEVES RN
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Gender | Male
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Dates
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Enumeration Date | 05/18/2023
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 4301 W MARKHAM ST
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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 | 501-526-6137
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Fax |
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Provider Business Mailing Address
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Address Line | 619 N POLK ST
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City | LITTLE ROCK
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State | AR
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Zip | 72205-3443
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Country | US
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Telephone | 501-912-0663
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | R053695
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License Number State | AR
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