MEDICARE: HAROLD B. BETTON, M.D. P.A.

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	MC-0637	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	:	1386673499
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAROLD B. BETTON, M.D. P.A.

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	:	PRESIDENT
Name	:	DR. HAROLD BYRD BETTON
Credential	:	MD
Telephone Number	:	501-376-1160

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	11/07/2011

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