Provider Demographics
NPI:1023097433
Name:ARP, ERIC ALLEN (DPM)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:ALLEN
Last Name:ARP
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 S COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-3904
Mailing Address - Country:US
Mailing Address - Phone:870-425-7363
Mailing Address - Fax:870-425-7387
Practice Address - Street 1:801 S COLLEGE ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-3904
Practice Address - Country:US
Practice Address - Phone:870-425-7363
Practice Address - Fax:870-425-7387
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR150213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR130362717Medicaid
AR180607716Medicaid
AR5T287Medicare PIN
AR180607716Medicaid
AR1142930001Medicare NSC
AR130362717Medicaid