Provider Demographics
NPI:1568469179
Name:CASPER, ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:CASPER
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 1:4202 S UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-7841
Mailing Address - Country:US
Mailing Address - Phone:501-562-4838
Mailing Address - Fax:501-562-1958
Practice Address - Street 1:4202 S UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-7841
Practice Address - Country:US
Practice Address - Phone:501-562-4838
Practice Address - Fax:501-562-1958
Is Sole Proprietor?:No
Enumeration Date:2005-06-29
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR3301207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR120004OtherUNITED HEALTH CARE
AR50939OtherBLUE CROSS BLUE SHIELD
AR105398001Medicaid
AR11112000000OtherQUALCHOICE
AR105398001Medicaid
ARC67972Medicare UPIN