Individual
DR. ANTHONY PHILLIP BUCOLO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10001 LILE DR, LITTLE ROCK, AR 72205-6217
(501) 552-6100
(501) 552-6199
Mailing address
10001 LILE DR, LITTLE ROCK, AR 72205-6217
(501) 552-6100
(501) 552-6199
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
N-5701
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104832001
—
AR
01
—
N5701
LICENSE NUMBER
AR
Enumeration date
07/01/2005
Last updated
06/30/2022
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