Provider Demographics
NPI:1962511808
Name:SCHMIDT, DAVID ALLAN (MD LLC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ALLAN
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:MD LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 HICKORY CREEK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212
Mailing Address - Country:US
Mailing Address - Phone:501-350-9606
Mailing Address - Fax:
Practice Address - Street 1:148 HICKORY CREEK CIRCLE
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212
Practice Address - Country:US
Practice Address - Phone:501-350-9606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC6879207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
547116972OtherMEDICARE LINKED
AR111270001Medicaid
547119672OtherMEDICARE LINKED
ARP00622061OtherRAILROAD MEDICARE
547119672OtherMEDICARE LINKED
ARP00622061OtherRAILROAD MEDICARE
AR111270001Medicaid