Individual
DECOTA MATTHEW HALSTED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4301 W MARKHAM ST # 589, LITTLE ROCK, AR 72205-7101
(501) 526-8148
Mailing address
3401 WEST MARKHAM STREET, LITTLE ROCK, AR 72205
(501) 499-3058
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
E-16098
AR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/27/2020
Last updated
04/17/2024
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