Provider Demographics
NPI:1447385422
Name:TOLLESON, CLAUDIA M (M D)
Entity Type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:M
Last Name:TOLLESON
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14300 CHENAL PKWY
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-5805
Mailing Address - Country:US
Mailing Address - Phone:501-202-1664
Mailing Address - Fax:501-202-1611
Practice Address - Street 1:14300 CHENAL PKWY
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-5805
Practice Address - Country:US
Practice Address - Phone:501-202-1664
Practice Address - Fax:501-202-1611
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC6257207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARC68197Medicare UPIN
AR51478Medicare ID - Type Unspecified