Provider Demographics
NPI:1902000557
Name:RHONDA J. MATTOX, PLLC
Entity Type:Organization
Organization Name:RHONDA J. MATTOX, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTOX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-240-4295
Mailing Address - Street 1:1901 SARATOGA DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-4489
Mailing Address - Country:US
Mailing Address - Phone:501-240-4295
Mailing Address - Fax:
Practice Address - Street 1:4000 W 13TH ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-3005
Practice Address - Country:US
Practice Address - Phone:501-240-4295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE48552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty