Individual
DR. EDWARD JASON VANDERBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6015 CHENONCEAU BLVD STE 140, LITTLE ROCK, AR 72223-4584
(501) 868-8410
(501) 868-8488
Mailing address
6015 CHENONCEAU BLVD STE 140, LITTLE ROCK, AR 72223-4584
(501) 868-8410
(501) 868-8488
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E4348
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162281001
—
AR
Enumeration date
07/13/2006
Last updated
12/29/2020
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