Individual
JACQUELINE CALDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2 SAINT VINCENT CIR, LITTLE ROCK, AR 72205-5423
(501) 664-4532
Mailing address
500 S UNIVERSITY AVE STE 500, LITTLE ROCK, AR 72205-5307
(501) 664-4532
(501) 663-4335
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
E5189
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07070023200
QUAL CHOICE
AR
05
—
164706001
—
AR
01
—
5N870
BLUE CROSS BLUE SHIELD
AR
01
—
P00628982
RR MEDICARE
AR
Enumeration date
04/25/2007
Last updated
03/16/2020
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