Individual
FREDERICK R BENTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4301 W MARKHAM ST, #520, LITTLE ROCK, AR 72205-7101
(501) 686-7428
(501) 686-5696
Mailing address
4301 W MARKHAM ST, #520, LITTLE ROCK, AR 72205-7101
(501) 686-7428
(501) 686-5696
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
E-4900
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06090017000
QUALCHOICE
AR
01
—
5N651
BLUE CROSS BLUE SHIELD
AR
01
—
5N6516884
ADDITIONAL MEDICARE
AR
05
—
64250665
—
KY
01
—
CQ2164
ADDITIONAL RAILROAD MCARE
AR
01
—
E4900
TRICARE
AR
01
—
P00355164
RAILROAD MEDICARE
AR
Enumeration date
01/17/2006
Last updated
09/12/2007
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