Provider Demographics
NPI:1073505541
Name:MCCARRON, ROBERT F (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:F
Last Name:MCCARRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:550 CLUB LANE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-3681
Mailing Address - Country:US
Mailing Address - Phone:501-329-1510
Mailing Address - Fax:501-329-5697
Practice Address - Street 1:550 CLUB LANE
Practice Address - Street 2:SUITE 1
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-3681
Practice Address - Country:US
Practice Address - Phone:501-329-1510
Practice Address - Fax:501-329-5697
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARC5220207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR200013843OtherRR MEDICARE
AR114607001Medicaid
AR12590000000OtherQUAL CHOICE
AR130436716Medicaid
AR51938OtherBCBS
AR114607001Medicaid
AR130436716Medicaid