Provider Demographics
NPI:1629470521
Name:LITTLE ROCK NEUROSURGERY CLINIC
Entity Type:Organization
Organization Name:LITTLE ROCK NEUROSURGERY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-558-0200
Mailing Address - Street 1:5 SAINT VINCENT CIR
Mailing Address - Street 2:SUITE 502
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5412
Mailing Address - Country:US
Mailing Address - Phone:501-558-0200
Mailing Address - Fax:501-558-0201
Practice Address - Street 1:5 SAINT VINCENT CIR
Practice Address - Street 2:SUITE 502
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5412
Practice Address - Country:US
Practice Address - Phone:501-558-0200
Practice Address - Fax:501-558-0201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004211363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty