MEDICARE: RICHARD (RICK) LYNN CROWNOVER MD

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	2085R0001X	Radiation Oncology Physician	E-13696	AR
2	2085R0001X	Radiation Oncology Physician	N1596	TX

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
2	188851302	OTHER	TX	CSN
3	8AM490	OTHER	TX	BLUE CROSS BLUE SHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	188851305	OTHER	TX	CSHCN

General Provider Information

NPI Number	:	1225238215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD (RICK) LYNN CROWNOVER MD

Provider Business Mailing Address
First Line	:	4301 W MARKHAM ST # 783
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-7101
Country	:	US
Telephone Number	:	501-686-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1455 HIGDON FERRY RD STE C
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6456
Country	:	US
Telephone Number	:	501-622-2100
Fax Number	:

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

Provider Enumeration Date	:	07/19/2007
Last Update Date	:	03/04/2025

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Directions to “ RICHARD (RICK) LYNN CROWNOVER MD” Practice Location

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