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Individual

DR. MANGARAJU CHAKKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
10100 KANIS RD, LITTLE ROCK, AR 72205-6202
(501) 255-6000
(501) 255-6400
Mailing address
10100 KANIS RD, LITTLE ROCK, AR 72205-6202
(501) 255-6000
(501) 255-6400

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
E4358
AR
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
E4358
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
157168001
AR
01
919591
MALP INS #
AR
Enumeration date
06/20/2006
Last updated
01/04/2011
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