Basic Information
| Provider Information | |||||||||
| NPI: | 1831184837 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHLABACH | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | D. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11001 EXECUTIVE CENTER DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722114393 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4796323855 | ||||||||
| FaxNumber: | 4796320356 | ||||||||
| Practice Location | |||||||||
| Address1: | 937 HIGHWAY 64 E | ||||||||
| Address2: | |||||||||
| City: | ALMA | ||||||||
| State: | AR | ||||||||
| PostalCode: | 729217382 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4796323855 | ||||||||
| FaxNumber: | 4796320356 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2005 | ||||||||
| LastUpdateDate: | 10/07/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | N7592 | AR | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 100202540A | 05 | OK | MEDICAID | 115770001 | 05 | AR | MEDICAID |