Provider Demographics
NPI:1699352609
Name:PALTING, ANGELICA (DO)
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:
Last Name:PALTING
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MEDICAL PARK DR STE 304
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-3745
Mailing Address - Country:US
Mailing Address - Phone:501-408-2429
Mailing Address - Fax:501-408-2822
Practice Address - Street 1:11904 KANIS RD STE H8
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3798
Practice Address - Country:US
Practice Address - Phone:501-408-2429
Practice Address - Fax:501-408-2822
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-25
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ARE-161222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program