Organization
ARKANSAS DERMATOLOGY CLINIC PA
Active
Organization
ARKANSAS DERMATOLOGY CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL JOSEPH RAQUE MD (PHYSICIAN OWNER)
(501) 666-5451
Entity
Organization
Contact information
Practice address
500 SOUTH UNIVERSITY AVENUE, SUITE 704, LITTLE ROCK, AR 72205-5309
(501) 666-5451
(501) 663-3335
Mailing address
500 SOUTH UNIVERSITY AVENUE, SUITE 704, LITTLE ROCK, AR 72205-5309
(501) 666-5451
(501) 663-3335
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
R2029
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54262
BCBS
AR
Enumeration date
05/01/2006
Last updated
11/16/2007
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up