Individual
RANDELL B MINTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9501 LILE DR, STE 600, LITTLE ROCK, AR 72205-6231
(501) 227-7596
(501) 227-7787
Mailing address
9501 LILE DR, STE 600, LITTLE ROCK, AR 72205-6231
(501) 227-7596
(501) 227-7787
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
C 8499
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5L583
BLUE CROSS BLUE SHIELD
AR
01
—
CC6745
RAILROAD MEDICARE
AR
01
—
CN1884
RAILROAD MEDICARE
AR
Enumeration date
05/25/2006
Last updated
10/04/2011
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