Provider Demographics
NPI:1619060589
Name:PRASAD, KRISHNAPPA ARTHUR (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISHNAPPA
Middle Name:ARTHUR
Last Name:PRASAD
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 1:11219 FINANCIAL CENTRE PKWY STE 240
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3859
Mailing Address - Country:US
Mailing Address - Phone:501-725-0830
Mailing Address - Fax:501-725-0825
Practice Address - Street 1:11219 FINANCIAL CENTRE PKWY STE 240
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3859
Practice Address - Country:US
Practice Address - Phone:501-725-0830
Practice Address - Fax:501-725-0825
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13076208100000X
ARE-70252081P2900X
TXM68332081P2900X
MO20080154372081P2900X
FLME1076782081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO937401OtherHEALTHLINK
MO627562/632335/634595OtherBC/BS
MO664774OtherMERCY
MO1619060589Medicaid
AR188837001Medicaid
MO353230OtherGHP
MO7740894OtherAETNA
MO937401OtherHEALTHLINK
MO150840003Medicare PIN
MOI65753Medicare UPIN
MOMA2027002Medicare PIN
MO1619060589Medicaid
MO146660003Medicare PIN
MO664774OtherMERCY
MOMA1142003Medicare PIN
AR5AL61Medicare PIN
MO146640003Medicare PIN
MO353230OtherGHP