MEDICARE: DR. HANNAH LANDRETH 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	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	E-20129	AR

General Provider Information

NPI Number	:	1396279311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HANNAH LANDRETH M.D.

Provider Business Mailing Address
First Line	:	1 CHILDRENS WAY # 664
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72202-3500
Country	:	US
Telephone Number	:	501-364-1100
Fax Number	:	501-978-6436

Provider Business Practice Location Address
First Line	:	1 CHILDRENS WAY
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72202-3500
Country	:	US
Telephone Number	:	501-364-1100
Fax Number	:	501-978-6436

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

Provider Enumeration Date	:	04/17/2017
Last Update Date	:	06/18/2026

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