Provider Demographics
NPI:1952488660
Name:SUAREZ, CARLOS ALBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ALBERTO
Last Name:SUAREZ
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 1:3291 S THOMPSON ST STE D101
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-7357
Mailing Address - Country:US
Mailing Address - Phone:479-419-9955
Mailing Address - Fax:888-960-2823
Practice Address - Street 1:2012 S PROMENADE BLVD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758
Practice Address - Country:US
Practice Address - Phone:479-616-1485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-7482207Q00000X
ORMD26979207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR278512Medicaid
ORCB3544OtherRR MEDICARE GROUP NUMBER
ORP00389916OtherRR MEDICARE NUMBER
ARE-7482OtherARKANSAS LICENSE
ORR0000WFBTVOtherMEDICARE GROUP PIN NUMBER
ARE-7482OtherARKANSAS LICENSE
OR278512Medicaid
ORCB3544OtherRR MEDICARE GROUP NUMBER
ORI67550Medicare UPIN
ORR135620Medicare PIN