Provider Demographics
NPI:1760476378
Name:BRESSINCK, RENIE E (MD)
Entity Type:Individual
Prefix:
First Name:RENIE
Middle Name:E
Last Name:BRESSINCK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9601 BAPTIST HEALTH DR.
Mailing Address - Street 2:SUITE 690
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6328
Mailing Address - Country:US
Mailing Address - Phone:501-227-8422
Mailing Address - Fax:501-537-2399
Practice Address - Street 1:9601 BAPTIST HEALTH DR
Practice Address - Street 2:SUITE 690
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6328
Practice Address - Country:US
Practice Address - Phone:501-227-8422
Practice Address - Fax:501-537-2399
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2020-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARC4366207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR826073040OtherRAILROAD MEDICARE
B90003Medicare UPIN
AR826073040OtherRAILROAD MEDICARE