Basic Information
| Provider Information | |||||||||
| NPI: | 1073509956 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCCOLLUM FLAXMAN | ||||||||
| FirstName: | NEESA | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 S UNIVERSITY AVE STE 500 | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722055307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016644532 | ||||||||
| FaxNumber: | 5016634335 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 SAINT VINCENT CIR | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722055423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016644532 | ||||||||
| FaxNumber: | 5016634335 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2005 | ||||||||
| LastUpdateDate: | 03/17/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | E-2798 | AR | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207L00000X | E-2798 | AR | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | S03153 | 01 | AR | NOVASYS | OTHER | P00001823 | 01 | AR | RAILROAD MEDICARE (LRPM) | OTHER | 149510001 | 05 | AR | MEDICAID | P00001818 | 01 | AR | RAILROAD MEDICARE | OTHER | 03080013000 | 01 | AR | QUAL CHOICE (LRPM) | OTHER | 5M491 | 01 | AR | BLUE CROSS BLUE SHIELD | OTHER | 171973300 | 01 | AR | US DEPT. OF LABOR OWCP | OTHER | 71033532430 | 01 | AR | QUAL CHOICE | OTHER | 770258801 | 01 | AR | ARKANSAS BREASTCARE | OTHER |