Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | E3469 | AR |
N | 111NI0900X | Internist | E3469 | AR |
N | 207RC0000X | Internist - Cardiovascular Disease | E-3469 | AR |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | E-3469 | AR |
NPI | 1245215243 |
---|---|
Provider Name | Dr. Prabhat K Hebbar |
First Address | North Little Rock, AR 72117-2650 |
Second Address | North Little Rock, AR 72117-2650 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 17/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
149428001 | (05) | AR |
H70927 | (02) | AR |