Provider Demographics
NPI:1639261043
Name:PERETTI, FRANK J (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:J
Last Name:PERETTI
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 1:4719 SUGAR MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-2092
Mailing Address - Country:US
Mailing Address - Phone:501-683-6122
Mailing Address - Fax:
Practice Address - Street 1:3 NATURAL RESOURCES DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-1539
Practice Address - Country:US
Practice Address - Phone:501-683-6122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA74983207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology