Provider Demographics
NPI:1285724856
Name:CARGILE, CHRISTOPHER S (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:S
Last Name:CARGILE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:S
Other - Last Name:CARGILE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4301 W MARKHAM ST # 783
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7101
Mailing Address - Country:US
Mailing Address - Phone:501-686-8000
Mailing Address - Fax:501-526-6562
Practice Address - Street 1:4301 W MARKHAM ST # 783
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-686-8000
Practice Address - Fax:501-526-6562
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-13652084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR146283001Medicaid
TX8BR226OtherBCBS
AR146283001Medicaid
5M064Medicare PIN
TX8L7412Medicare PIN
TX8BR226OtherBCBS