Provider Demographics
NPI:1427012962
Name:TRUSSELL, ANNE ROWLAND (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:ROWLAND
Last Name:TRUSSELL
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 1:9501 LILE DR
Mailing Address - Street 2:SUITE 940
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6225
Mailing Address - Country:US
Mailing Address - Phone:501-228-6122
Mailing Address - Fax:501-228-2240
Practice Address - Street 1:9501 LILE DR
Practice Address - Street 2:SUITE 940
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6225
Practice Address - Country:US
Practice Address - Phone:501-228-6122
Practice Address - Fax:501-228-2240
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-8314207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G10489Medicare UPIN
5J803Medicare ID - Type Unspecified