MEDICARE: DR. ROBERT R CAMFERDAM 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	207R00000X	Internal Medicine Physician	E6250	AR
2	207RN0300X	Nephrology Physician	E6250	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053529321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT R CAMFERDAM M.D.

Provider Business Mailing Address
First Line	:	PO BOX 17930
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72222-7930
Country	:	US
Telephone Number	:	501-663-0490
Fax Number	:	501-663-5949

Provider Business Practice Location Address
First Line	:	403 S POPLAR ST STE D
Second Line	:
City	:	SEARCY
State	:	AR
Zip	:	72143-6000
Country	:	US
Telephone Number	:	501-279-7077
Fax Number	:	501-279-3970

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

Provider Enumeration Date	:	05/19/2007
Last Update Date	:	04/16/2021

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