Provider Demographics
NPI:1477704120
Name:KATHRYN T. CHENAULT, M.D, P.A.
Entity Type:Organization
Organization Name:KATHRYN T. CHENAULT, M.D, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:T
Authorized Official - Last Name:CHENAULT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-945-4710
Mailing Address - Street 1:PO BOX 16563
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72231-6563
Mailing Address - Country:US
Mailing Address - Phone:501-945-4710
Mailing Address - Fax:501-955-9027
Practice Address - Street 1:3500 SPRINGHILL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2950
Practice Address - Country:US
Practice Address - Phone:501-945-4710
Practice Address - Fax:501-955-9027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE0780261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service