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LITTLE ROCK CANCER CLINIC P.A. NPI 1902832330


NPI Information

NPI: 1902832330
Provider Name: LITTLE ROCK CANCER CLINIC, P.A.
Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

Address:
500 S UNIVERSITY AVE
SUITE 811
LITTLE ROCK, AR
ZIP 72205
Phone: (501) 661-1822
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LITTLE ROCK CANCER CLINIC, P.A. is a hematology and oncology internal medicine in Little Rock, AR. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. LITTLE ROCK CANCER CLINIC, P.A. NPI is 1902832330. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

500 S UNIVERSITY AVE
SUITE 811
LITTLE ROCK, AR
ZIP 72205-302
Phone: (501) 661-1822
Fax: (501) 666-0266

The provider's authorized official is Luis Reyes .
The authorized official title is Office Manager and has the following contact phone number (501) 661-1822.

The enumeration date for this NPI number is 6/25/2006 and was last updated on 1/13/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RH0003XInternal MedicineHematology & OncologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
104D0922485OTHERC.L.I.A. NUMBER FOR LAB
2472130OTHERHEALTHLINK PPO
35239121OTHERAETNA
4130483002MEDICAIDARKANSAS
51902832330OTHERMERCY HEALTH PLANS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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