| Endoscopy Center Of Little Rock,llc | |
|
4200 N Rodney Parham Rd Ste 203 Little Rock AR 72212-2460 | |
| (501) 228-4445 | |
| (501) 228-0110 |
| Full Name | Endoscopy Center Of Little Rock,llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4200 N Rodney Parham Rd Ste 203, Little Rock, Arkansas |
| Authorized Official Name and Position | Alisa Petet-mcelfresh (MANAGING MEMBER) |
| Authorized Official Contact | 0166469805 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Endoscopy Center Of Little Rock,llc 4200 N Rodney Parham Rd Little Rock AR 72212-2460 Ph: (501) 228-4445 | Endoscopy Center Of Little Rock,llc 4200 N Rodney Parham Rd Ste 203 Little Rock AR 72212-2460 Ph: (501) 228-4445 |
| NPI Number | 1396727418 |
|---|---|
| Provider Enumeration Date | 11/15/2005 |
| Last Update Date | 12/11/2023 |
| Medicare PECOS PAC ID | 6406740075 |
|---|---|
| Medicare Enrollment ID | O20040212000900 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396727418 | NPI | - | NPPES |
| 154933128 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Secondary |
| 261QA1903X | Clinic/center - Ambulatory Surgical | (Arkansas) | Primary |
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