Basic Information
| Provider Information | |||||||||
| NPI: | 1578944385 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FOOT & ANKLE ASSOCIATES OF CENTRAL ARKANSAS, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4200 N RODNEY PARHAM RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722122461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5015348888 | ||||||||
| FaxNumber: | 5015348891 | ||||||||
| Practice Location | |||||||||
| Address1: | 1900 MALVERN AVE | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719017759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5013212444 | ||||||||
| FaxNumber: | 5013219521 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2015 | ||||||||
| LastUpdateDate: | 06/17/2015 | ||||||||
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| AuthorizedOfficialLastName: | DELLINGER | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
| AuthorizedOfficialMiddleName: | ALEX | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5015348888 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DPM | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0103X | 167 | AR | Y | 193400000X SINGLE SPECIALTY GROUP | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
No ID Information.