NPI 1952838864 · live from the CMS NPI Registry
Russell James Roark, MD
Internal Medicine in Little Rock, AR. National Provider Identifier 1952838864, active.
NPI record
| NPI | 1952838864 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine 207R00000X |
| Practice location | 4301 W Markham St # 567, Little Rock, AR 72205 |
| Practice phone | 501-686-8000 |
| Mailing address | 4301 W Markham St # 783, Little Rock, AR 72205 |
| Enumerated | May 23, 2017 |
| Last updated | September 5, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine | 207R00000X | BP10060880 (TX) |
| Internal Medicine, Gastroenterology | 207RG0100X | E-18297 (AR) |
| Internal Medicine primary | 207R00000X | E-18297 (AR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.