Provider Demographics
NPI:1538120316
Name:QUINN, BRIAN DENNIS (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:DENNIS
Last Name:QUINN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LILE CT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6242
Mailing Address - Country:US
Mailing Address - Phone:501-225-7711
Mailing Address - Fax:501-225-7108
Practice Address - Street 1:1 LILE CT
Practice Address - Street 2:SUITE 101
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6242
Practice Address - Country:US
Practice Address - Phone:501-225-7711
Practice Address - Fax:501-225-7108
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE0485207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR127711001Medicaid
AR127711001Medicaid
AR127711001Medicaid