Individual
INDRANIL CHAKRABORTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4301 W MARKHAM ST #783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
(501) 526-6562
Mailing address
4301 W MARKHAM ST #783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
(501) 526-6562
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
E-4315
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06070015300
QUALCHOICE
AR
05
—
160491001
—
AR
01
—
5N445
BCBS
AR
01
—
E4315
TRICARE
AR
01
—
P00350630
RAILROAD MEDICARE 1
AR
Enumeration date
09/22/2006
Last updated
09/07/2016
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