Individual
DR. ROBERT JULIAN VANDEWALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 CHILDRENS WAY # 210, LITTLE ROCK, AR 72202-3500
(501) 364-6889
(501) 364-1649
Mailing address
1 CHILDRENS WAY # 653, LITTLE ROCK, AR 72202-3500
(501) 364-1100
(501) 364-4082
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
E15428
AR
2086S0102X
Surgical Critical Care Physician
Primary
E15428
AR
2086S0120X
Pediatric Surgery Physician
080383
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/12/2010
Last updated
10/06/2022
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