Provider Demographics
NPI:1407814940
Name:DELLINGER, RICHARD A (DPM)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:DELLINGER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 N RODNEY PARHAM RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-2458
Mailing Address - Country:US
Mailing Address - Phone:501-534-8888
Mailing Address - Fax:501-534-8891
Practice Address - Street 1:10018 WEST MARKHAM
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2130
Practice Address - Country:US
Practice Address - Phone:501-534-8888
Practice Address - Fax:501-534-8891
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR167213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARP00035400OtherRAILROAD MEDICARE
ARDA2254OtherRAILROAD MEDICARE GROUP
AR136850717Medicaid
AR5C803Medicare PIN
4858190001Medicare NSC
ARDA2254OtherRAILROAD MEDICARE GROUP
ARU74897Medicare UPIN
AR136850717Medicaid