# LITTLE ROCK INTERNAL MEDICINE

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

## Provider details

- **NPI number:** 1285774059
- **Authorized official:** LISA A CHILDERS (CREDENTIALING)
- **Authorized official phone:** (501) 224-1690

## Contact information

- **Practice address:** 5918 LEE AVE, LITTLE ROCK, AR 72205-3326
- **Practice address phone:** (501) 224-1690
- **Practice address fax:** (501) 224-1927
- **Mailing address:** 5918 LEE AVE, LITTLE ROCK, AR 72205-3326
- **Mailing address phone:** (501) 224-1690
- **Mailing address fax:** (501) 224-1927

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/08/2007
- **Last updated:** 08/22/2020