MEDICARE: ABIGAIL LEIGH DELOACH 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	208600000X	Surgery Physician	E19595	AR

General Provider Information

NPI Number	:	1598394405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL LEIGH DELOACH MD

Provider Business Mailing Address
First Line	:	3401 SPRINGHILL DR STE 245
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72117-2926
Country	:	US
Telephone Number	:	501-945-4422
Fax Number	:	501-955-6052

Provider Business Practice Location Address
First Line	:	3401 SPRINGHILL DR STE 245
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72117-2926
Country	:	US
Telephone Number	:	501-945-4422
Fax Number	:	501-955-6052

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

Provider Enumeration Date	:	04/02/2020
Last Update Date	:	12/02/2025

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