Provider Demographics
NPI:1477532844
Name:MONSON, ROBERTA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTA
Middle Name:ANN
Last Name:MONSON
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 1:47 GLOUCESTER DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-2117
Mailing Address - Country:US
Mailing Address - Phone:501-224-2656
Mailing Address - Fax:501-224-2656
Practice Address - Street 1:47 GLOUCESTER DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72227-2117
Practice Address - Country:US
Practice Address - Phone:501-224-2656
Practice Address - Fax:501-224-2656
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC5258207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARC5258OtherLICENSE NUMBER
ARC5258OtherLICENSE NUMBER
AR53746Medicare ID - Type UnspecifiedMEDICARE