Provider Demographics
NPI:1659387181
Name:PILLOW, EDWARD L (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:L
Last Name:PILLOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:101 SHIRLEY HICKS DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AR
Mailing Address - Zip Code:72342-8852
Mailing Address - Country:US
Mailing Address - Phone:870-572-5996
Mailing Address - Fax:870-572-4471
Practice Address - Street 1:101 SHIRLEY HICKS DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AR
Practice Address - Zip Code:72342-8852
Practice Address - Country:US
Practice Address - Phone:870-572-5996
Practice Address - Fax:870-572-4471
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE4870208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR162838001Medicaid
AR162838001Medicaid