Provider Demographics
NPI:1043383706
Name:FOOT & ANKLE ASSOCIATES OF CENTRAL ARKANSAS, PLLC
Entity Type:Organization
Organization Name:FOOT & ANKLE ASSOCIATES OF CENTRAL ARKANSAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALEX
Authorized Official - Last Name:DELLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:501-534-8888
Mailing Address - Street 1:4200 N RODNEY PARHAM RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-2458
Mailing Address - Country:US
Mailing Address - Phone:501-534-8888
Mailing Address - Fax:501-534-8891
Practice Address - Street 1:4200 N RODNEY PARHAM RD STE 100
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212-2458
Practice Address - Country:US
Practice Address - Phone:501-534-8888
Practice Address - Fax:501-534-8891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR167213ES0103X
AR112213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARP00035400OtherRAILROAD MEDICARE
AR150024748Medicaid
ARP00011743OtherRAILROAD MEDICARE
ARDA2254OtherRAILROAD MEDICARE GROUP
AR150024748Medicaid
AR5S271C803Medicare PIN
AR4858190001Medicare NSC
AR5S271Medicare PIN
AR5U185C803Medicare PIN
AR5C803Medicare PIN