Provider Demographics
NPI:1194833194
Name:REMMEL, RAYMOND ROLAND (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:ROLAND
Last Name:REMMEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11219 FINANCIAL CENTRE PKWY
Mailing Address - Street 2:SUITE 303
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3800
Mailing Address - Country:US
Mailing Address - Phone:501-223-2622
Mailing Address - Fax:501-223-8760
Practice Address - Street 1:11219 FINANCIAL CENTRE PKWY
Practice Address - Street 2:SUITE 303
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3800
Practice Address - Country:US
Practice Address - Phone:501-223-2622
Practice Address - Fax:501-223-8760
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR4216174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR119443001Medicaid
AR119443001Medicaid
AR54803Medicare ID - Type Unspecified