Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | C-4330 | AR |
NPI | 1336359546 |
---|---|
Provider Name | Dr. Edwin Louis Bird |
First Address | Little Rock, AR 72211-4453 |
Second Address | Little Rock, AR 72211-4453 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 08/07/2007 |