# DIAGNOSTIC PHYSICIANS OF ARKANSAS, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265544373
- **Authorized official:** MR. RONALD EDWARD EDGERTON (ADMINISTRATOR)
- **Authorized official phone:** (501) 955-1156

## Contact information

- **Practice address:** 4509 E MCCAIN BLVD, NORTH LITTLE ROCK, AR 72117-2902
- **Practice address phone:** (501) 945-8080
- **Practice address fax:** (501) 945-5040
- **Mailing address:** 4509 E MCCAIN BLVD, NORTH LITTLE ROCK, AR 72117-2902
- **Mailing address phone:** (501) 945-8080
- **Mailing address fax:** (501) 945-5040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | MC2053 | AR | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 09/06/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5C147 | BLUE CROSS BLUE SHIELD | AR |
| 01 | — | CF9997 | RAIL ROAD MEDICARE | AR |