Dr. Ethan J Schock
Sports Medicine Orthopaedic Surgeon
800 Fair Park Blvd
Little Rock
, Arkansas 72204
Dr. Ethan J Schock
Sports Medicine Orthopaedic Surgeon
800 Fair Park Blvd
Little Rock
, Arkansas 72204
(501) 666-9653
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About
Features
Specialties
- Sports Medicine Orthopaedic Surgeon
Languages spoken
- English
Location
First Address
- Dr. Ethan J Schock
- 800 Fair Park Blvd
- Little Rock, AR
- Zip : 72204-1720
- Fax : (501) 666-9653
- Phone : (501) 663-3647
Second Address
- Dr. Ethan J Schock
- 800 Fair Park Blvd
- Little Rock, AR
- Zip : 72204
- Fax : (501) 666-9653
- Phone : (501) 663-3647
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | E-2961 | AR |
National Provider Identifier
| NPI | 1033197215 |
|---|---|
| Provider Name | Dr. Ethan J Schock |
| First Address | Little Rock, AR 72204-1720 |
| Second Address | Little Rock, AR 72204 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/01/2006 |
| Last Update Date | 06/07/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 145157001 | (05) | AR |
| 5L876C207 | MEDICARE PTAN (01) | AR |
| G71471 | (02) | AR |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.