Individual
CHARLES WILLIAM DEATON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 S UNIVERSITY AVE, STE 600, LITTLE ROCK, AR 72205-5302
(501) 664-3914
(501) 664-5246
Mailing address
500 S UNIVERSITY AVE, STE 101, LITTLE ROCK, AR 72205-5302
(501) 664-3914
(501) 664-5246
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
R3975
AR
2085R0204X
Vascular & Interventional Radiology Physician
R3975
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115746001
—
AR
Enumeration date
10/04/2005
Last updated
12/06/2011
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