Provider Demographics
NPI:1679598684
Name:REDING, DAVID LAWRENCE (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:LAWRENCE
Last Name:REDING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11001 EXECUTIVE CENTER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4316
Mailing Address - Country:US
Mailing Address - Phone:501-224-0200
Mailing Address - Fax:501-224-2292
Practice Address - Street 1:9601 LILE DR
Practice Address - Street 2:SUITE 310
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6321
Practice Address - Country:US
Practice Address - Phone:501-224-0200
Practice Address - Fax:501-224-2292
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARC4523207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR536530OtherHEALTHLINK
AR104522001Medicaid
AR4673408OtherAETNA
AR620019OtherUNITED
AR14127000000OtherQUALCHOICE
AR14127000000OtherQUALCHOICE
AR54279Medicare PIN
ARD04872Medicare UPIN