Provider Demographics
NPI:1275595308
Name:KUPERMAN, IRVING (MD)
Entity Type:Individual
Prefix:DR
First Name:IRVING
Middle Name:
Last Name:KUPERMAN
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 1:5300 MABELVALE PIKE
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72209-1820
Mailing Address - Country:US
Mailing Address - Phone:501-568-2100
Mailing Address - Fax:501-568-7102
Practice Address - Street 1:5300 MABELVALE PIKE
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-1820
Practice Address - Country:US
Practice Address - Phone:501-568-2100
Practice Address - Fax:501-568-7102
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR1594207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR52996Medicare ID - Type Unspecified
ARB90368Medicare UPIN