Individual
DR. ROBERT WARREN BALENTINE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2302 COLLEGE AVE, CONWAY, AR 72034-6297
(501) 329-3831
Mailing address
147 SUMMIT VALLEY CIR, MAUMELLE, AR 72113-6096
(501) 258-4433
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-6063
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1-09174-0
—
LA
01
—
E-6063
ARKANSAS STATE LICENSE
AR
Enumeration date
01/15/2007
Last updated
03/07/2023
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