Individual
DANIEL DILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4202 S UNIVERSITY AVE, LITTLE ROCK, AR 72204-7841
(501) 562-4838
(501) 562-1958
Mailing address
4202 S UNIVERSITY AVE, LITTLE ROCK, AR 72204-7841
(501) 562-4838
(501) 562-1958
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C4472
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104404001
—
AR
01
—
11114000000
QUALCHOICE
AR
01
—
120025
UNITED HEALTHCARE
AR
01
—
51379
BLUE CROSS BLUE SHIELD
AR
Enumeration date
06/29/2005
Last updated
02/21/2012
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