MEDICARE: DR. JUSTIN MARC RABINOWITZ 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	207X00000X	Orthopaedic Surgery Physician	2020011277	MO
2	207X00000X	Orthopaedic Surgery Physician	E-14461	AR

General Provider Information

NPI Number	:	1417338773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUSTIN MARC RABINOWITZ MD

Provider Business Mailing Address
First Line	:	PO BOX 251420
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72225-1420
Country	:	US
Telephone Number	:	501-686-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	10815 COLONEL GLENN RD
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72204-8011
Country	:	US
Telephone Number	:	501-406-9228
Fax Number	:

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

Provider Enumeration Date	:	06/12/2015
Last Update Date	:	09/02/2021

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