NPI 1417698317

Samuil Ivanovsky

Practitioner General Practice Physician Little Rock, AR

Practice location

Address: 4301 W Markham St # 634, Little Rock, AR 72205-7199
Phone: (501) 686-7592

Registered specialties (2)

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence E-19099 (AR)

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1417698317
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Apr 2022
Record last updated: 7 Aug 2026

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.