MEDICARE: DR. HAROLD BYRD BETTON 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	207Q00000X	Family Medicine Physician	C-3518	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	:	1275528267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAROLD BYRD BETTON M.D.

Provider Business Mailing Address
First Line	:	1505 W 11TH ST
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72202-4619
Country	:	US
Telephone Number	:	501-376-1160
Fax Number	:	501-376-3977

Provider Business Practice Location Address
First Line	:	1505 W 11TH ST
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72202-4619
Country	:	US
Telephone Number	:	501-376-1160
Fax Number	:	501-376-3977

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

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	12/23/2009

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