Provider Demographics
NPI:1275504516
Name:ROLLINS, LINDA GAIL (M D)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:GAIL
Last Name:ROLLINS
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 AUTUMN ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211
Mailing Address - Country:US
Mailing Address - Phone:501-227-6363
Mailing Address - Fax:501-227-8629
Practice Address - Street 1:904 AUTUMN ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211
Practice Address - Country:US
Practice Address - Phone:501-227-6363
Practice Address - Fax:501-227-8629
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE0009207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR129629001Medicaid
ARG33553Medicare UPIN
AR129629001Medicaid