Provider Demographics
NPI:1427577089
Name:OBREGON, FABIOLA DEL CARMEN (MD)
Entity Type:Individual
Prefix:
First Name:FABIOLA
Middle Name:DEL CARMEN
Last Name:OBREGON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FABIOLA
Other - Middle Name:DEL CARMEN
Other - Last Name:ESCOBAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1301 WILSON RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6659
Mailing Address - Country:US
Mailing Address - Phone:501-225-0576
Mailing Address - Fax:501-225-6789
Practice Address - Street 1:1301 WILSON RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6659
Practice Address - Country:US
Practice Address - Phone:501-225-0576
Practice Address - Fax:501-225-6789
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ARE155482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program