Organization
PETITE ROCHE EMERGENCY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES L. MURPHY (EXECUTIVE VICE PRESIDENT)
21471224000
Entity
Organization
Contact information
Practice address
2 SAINT VINCENT CIR, LITTLE ROCK, AR 72205-5423
(501) 664-5360
(214) 712-2487
Mailing address
1717 MAIN ST, SUITE 5200, DALLAS, TX 75201-4612
(214) 712-2000
(214) 712-2487
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5F619
BLUE SHIELD
AR
Enumeration date
08/31/2006
Last updated
04/20/2008
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