Provider Demographics
NPI:1093807745
Name:ROBERT T LOVE III MD PLLC
Entity Type:Organization
Organization Name:ROBERT T LOVE III MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:T
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:501-907-7300
Mailing Address - Street 1:3343 SPRINGHILL DRIVE
Mailing Address - Street 2:SUITE #3010
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117
Mailing Address - Country:US
Mailing Address - Phone:501-907-7300
Mailing Address - Fax:
Practice Address - Street 1:3343 SPRINGHILL DRIVE
Practice Address - Street 2:SUITE #3010
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117
Practice Address - Country:US
Practice Address - Phone:501-907-7300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARARE3915174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR138412001Medicaid
ARF75493Medicare UPIN
AR138412001Medicaid