Provider Demographics
NPI:1356899173
Name:AL-JABERI, LINA (MD)
Entity type:Individual
Prefix:
First Name:LINA
Middle Name:
Last Name:AL-JABERI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LINA
Other - Middle Name:
Other - Last Name:AL JABERI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 251418
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72225-1418
Mailing Address - Country:US
Mailing Address - Phone:501-364-1100
Mailing Address - Fax:501-364-4082
Practice Address - Street 1:1 CHILDRENS WAY # 512-2
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3500
Practice Address - Country:US
Practice Address - Phone:501-364-1660
Practice Address - Fax:501-364-5339
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIA421522785995208000000X
ARE-14963208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics