Individual
ROB LAVENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
Mailing address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
C-5790
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11868000000
QUALCHOICE
AR
01
—
53065
BCBS
AR
Enumeration date
10/13/2006
Last updated
01/31/2008
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