| Arkansas Neurology & Epilepsy Center Pa | |
|
5100 W 12th St Little Rock AR 72204-1855 | |
| (501) 663-2200 | |
| (501) 954-7624 |
| Full Name | Arkansas Neurology & Epilepsy Center Pa |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 5100 W 12th St, Little Rock, Arkansas |
| Authorized Official Name and Position | Willis Courtney (OWNER) |
| Authorized Official Contact | 5016632200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Arkansas Neurology & Epilepsy Center Pa Po Box 56170 Little Rock AR 72215-6170 Ph: (501) 663-2200 | Arkansas Neurology & Epilepsy Center Pa 5100 W 12th St Little Rock AR 72204-1855 Ph: (501) 663-2200 |
| NPI Number | 1992822357 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992822357 | NPI | - | NPPES |
| 1467418228 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | C7679 (Arkansas) | Primary |
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