Basic Information
| Provider Information | |||||||||
| NPI: | 1285696070 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRITTON | ||||||||
| FirstName: | CALVIN | ||||||||
| MiddleName: | P. | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | III | ||||||||
| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10018 W MARKHAM | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722052130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5015348888 | ||||||||
| FaxNumber: | 5015348891 | ||||||||
| Practice Location | |||||||||
| Address1: | 10018 W MARKHAM | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722052130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5015348888 | ||||||||
| FaxNumber: | 5015348891 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2006 | ||||||||
| LastUpdateDate: | 01/07/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | 112 | AR | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist |
ID Information
| ID | Type | State | Issuer | Description | DA2254 | 01 | AR | RAILROAD GROUP MEDICARE | OTHER | P00011743 | 01 | AR | RAILROAD MEDICARE | OTHER |