NPI 1497713580

Arkansas Dermatology Clinic PA

Organisation Dermatology Physician Little Rock, AR

Practice location

Address: 500 South University Avenue Suite 704, Little Rock, AR 72205-5309
Phone: (501) 666-5451
Fax: (501) 663-3335

Authorised official

Name: Carl Joseph Raque
Title: Physician Owner
Phone: (501) 666-5451

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence R2029 (AR)

Other Dermatology providers in Arkansas →

Registry record

NPI: 1497713580
Entity type: Organization
NPI issued: 1 May 2006
Record last updated: 16 Nov 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.