Provider Demographics
NPI:1437871571
Name:POLLOCK, BAILEY WHITTINGTON (PA-C)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:WHITTINGTON
Last Name:POLLOCK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BAILEY
Other - Middle Name:W
Other - Last Name:POLLOCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:4220 N RODNEY PARHAM RD STE 320
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-2466
Mailing Address - Country:US
Mailing Address - Phone:501-246-1042
Mailing Address - Fax:501-217-3809
Practice Address - Street 1:4220 N RODNEY PARHAM RD STE 320
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212-2466
Practice Address - Country:US
Practice Address - Phone:501-246-1042
Practice Address - Fax:501-217-3809
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1177669207N00000X
ARPA-1110363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207N00000XAllopathic & Osteopathic PhysiciansDermatology