MEDICARE: DR. STEPHEN M CHATELAIN M.D. FACOG

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	174400000X	Specialist	R3974	AR
2	207VM0101X	Maternal & Fetal Medicine Physician	R-3974	AR
3	174400000X	Specialist	R-3974	AR

General Provider Information

NPI Number	:	1477529188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN M CHATELAIN M.D. FACOG

Provider Business Mailing Address
First Line	:	11001 EXECUTIVE CENTER DRIVE
Second Line	:	SUITE 200
City	:	LITTLE ROCK
State	:	AR
Zip	:	72211-4393
Country	:	US
Telephone Number	:	501-217-8467
Fax Number	:	501-217-8468

Provider Business Practice Location Address
First Line	:	9501 BAPTIST HEALTH DRIVE
Second Line	:	SUITE 810
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-6225
Country	:	US
Telephone Number	:	501-217-8467
Fax Number	:	501-217-8468

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

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	09/25/2014

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Directions to “ DR. STEPHEN M CHATELAIN M.D. FACOG” Practice Location

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