Provider Demographics
NPI:1649686643
Name:MEASE, ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:MEASE
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4815 W MARKHAM ST
Mailing Address - Street 2:SLOT 16
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3866
Mailing Address - Country:US
Mailing Address - Phone:501-280-4511
Mailing Address - Fax:501-661-2464
Practice Address - Street 1:4815 W MARKHAM ST
Practice Address - Street 2:SLOT 16
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3866
Practice Address - Country:US
Practice Address - Phone:501-280-4511
Practice Address - Fax:501-661-2464
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC12121208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics