Individual
JOSEPH CHACKO
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
Mailing address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
E-4513
AR
207WX0109X
Neuro-ophthalmology Physician
E-4513
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158035001
—
AR
01
—
P00293816
RAILROAD MEDICARE
AR
Enumeration date
10/13/2006
Last updated
07/21/2021
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