Provider Demographics
NPI:1114151404
Name:WEBSTER, SARAHROSE SCHNEIDER (MD)
Entity Type:Individual
Prefix:
First Name:SARAHROSE
Middle Name:SCHNEIDER
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11001 EXECUTIVE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4393
Mailing Address - Country:US
Mailing Address - Phone:479-573-7940
Mailing Address - Fax:479-573-7941
Practice Address - Street 1:1500 DODSON AVE STE 175
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72901-5180
Practice Address - Country:US
Practice Address - Phone:479-573-7940
Practice Address - Fax:479-573-7941
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE9384208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR211512001Medicaid