National Provider Identifier Database

LITTLE ROCK CANCER CLINIC PA
Hematology & Oncology

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.


Contact Information

LITTLE ROCK CANCER CLINIC, P.A.
500 S UNIVERSITY AVE
SUITE 811
LITTLE ROCK, AR72205-5302
Phone: 501-661-1822
Fax: 501-666-0266
Website:
Specialty Taxonomy Code
* Hematology & Oncology 207RH0003X

* Indicates primary specialty

NPI Profile & details for LITTLE ROCK CANCER CLINIC, P.A.

NPI Number 1902832330
Legal business name
LBN
LITTLE ROCK CANCER CLINIC, P.A.
Authorized official LUIS REYES - (OFFICE MANAGER)
Entity Organization
Organization subpart No
Enumeration date 06/25/2006
Last updated 01/13/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • AR Medicaid: 130483002
  • Other: 5239121 AETNA
  • Other: 04D0922485 C.L.I.A. NUMBER FOR LAB
  • Other: 472130 HEALTHLINK PPO
  • Other: 1902832330 MERCY HEALTH PLANS

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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