Provider Demographics
NPI:1336135805
Name:ROULIER, JULIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:A
Last Name:ROULIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 SIDNEY ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7203
Mailing Address - Country:US
Mailing Address - Phone:870-793-1126
Mailing Address - Fax:870-793-1180
Practice Address - Street 1:1215 SIDNEY ST
Practice Address - Street 2:STE 300
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7203
Practice Address - Country:US
Practice Address - Phone:870-793-1126
Practice Address - Fax:870-793-1180
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE2723207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR141602001Medicaid
191640000OtherQUAL CHOICE
AR5L654Medicare ID - Type Unspecified
ARW13141Medicare UPIN
AR080175435Medicare ID - Type UnspecifiedRAILROAD