Provider Demographics
NPI:1821179474
Name:JAMES, LARRY CHRISTOPHER (CRNA)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:CHRISTOPHER
Last Name:JAMES
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SHACKLEFORD PLZ
Mailing Address - Street 2:SUITE 212
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-1826
Mailing Address - Country:US
Mailing Address - Phone:501-223-9991
Mailing Address - Fax:501-223-9925
Practice Address - Street 1:5201 N SHORE DR
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72118-5312
Practice Address - Country:US
Practice Address - Phone:501-748-8000
Practice Address - Fax:501-748-8159
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARCO1225 CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5T963Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER