MEDICARE: NEESA J MCCOLLUM FLAXMAN 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	207LP2900X	Pain Medicine (Anesthesiology) Physician	E-2798	AR
2	207L00000X	Anesthesiology Physician	E-2798	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00001818	OTHER	AR	RAILROAD MEDICARE
9	P00001823	OTHER	AR	RAILROAD MEDICARE (LRPM)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	171973300	OTHER	AR	US DEPT. OF LABOR OWCP
2	5M491	OTHER	AR	BLUE CROSS BLUE SHIELD
4	S03153	OTHER	AR	NOVASYS
5	03080013000	OTHER	AR	QUAL CHOICE (LRPM)
6	71033532430	OTHER	AR	QUAL CHOICE
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	770258801	OTHER	AR	ARKANSAS BREASTCARE

General Provider Information

NPI Number	:	1073509956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEESA J MCCOLLUM FLAXMAN M.D.

Provider Business Mailing Address
First Line	:	8201 CANTRELL RD STE 250
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72227-2503
Country	:	US
Telephone Number	:	501-466-7246
Fax Number	:	501-456-7246

Provider Business Practice Location Address
First Line	:	8201 CANTRELL RD STE 250
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72227-2503
Country	:	US
Telephone Number	:	501-466-7246
Fax Number	:	501-456-7246

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

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	05/08/2023

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