Organization
LORETTA DEPALO, M.D, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORETTA DEPALO M.D. (OWNER)
(501) 219-7904
Entity
Organization
Contact information
Practice address
1701 S SHACKLEFORD RD, LITTLE ROCK, AR 72211-4335
(501) 219-7904
(501) 219-7909
Mailing address
1701 S SHACKLEFORD RD, LITTLE ROCK, AR 72211-4335
(501) 219-7904
(501) 219-7909
Taxonomy
Speciality
Code
Description
License number
State
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125797001
—
AR
01
—
E0806
ELECTRONIC SUBMITTER
AR
Enumeration date
04/16/2007
Last updated
10/23/2012
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