MEDICARE: ADOLFO D. GARNICA 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	2080P0205X	Pediatric Endocrinology Physician	15033	OK
2	208000000X	Pediatrics Physician	15033	OK
3	207SG0202X	Clinical Biochemical Genetics Physician	E-5996	AR
4	207SG0201X	Clinical Genetics (M.D.) Physician	E-5996	AR
5	2080P0205X	Pediatric Endocrinology Physician	E-5996	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	:	1457320913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADOLFO D. GARNICA MD

Provider Business Mailing Address
First Line	:	1 CHILDRENS WAY # 653
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72202-3500
Country	:	US
Telephone Number	:	501-364-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 CHILDRENS WAY # 653
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72202-3500
Country	:	US
Telephone Number	:	501-364-1100
Fax Number	:

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

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	06/16/2009

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Directions to “ ADOLFO D. GARNICA MD” Practice Location

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