Individual
PAUL BLAKE CHISM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9601 BAPTIST HEALTH DR STE 1100, LITTLE ROCK, AR 72205-6333
(501) 748-3210
(501) 227-9151
Mailing address
9601 BAPTIST HEALTH DR STE 1100, LITTLE ROCK, AR 72205-6333
(501) 748-3210
(501) 227-9151
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
E-10635
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D86827
LICENSE
MD
Enumeration date
04/04/2014
Last updated
11/14/2024
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