MEDICARE: DR. MEGHAN FREILEY REPP M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	E-7512	AR

General Provider Information

NPI Number	:	1033351507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEGHAN FREILEY REPP M.D.

Provider Business Mailing Address
First Line	:	2301 SPRINGHILL RD STE 200
Second Line	:
City	:	BRYANT
State	:	AR
Zip	:	72019-7566
Country	:	US
Telephone Number	:	501-847-2500
Fax Number	:

Provider Business Practice Location Address
First Line	:	2301 SPRINGHILL RD STE 200
Second Line	:
City	:	BRYANT
State	:	AR
Zip	:	72019-7566
Country	:	US
Telephone Number	:	501-847-2500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2009
Last Update Date	:	06/13/2013

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