Provider Demographics
NPI:1679843445
Name:LITTLE ROCK ENDOCRINOLOGY SERVICES
Entity type:Organization
Organization Name:LITTLE ROCK ENDOCRINOLOGY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:A
Authorized Official - Last Name:NIMMO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-762-8056
Mailing Address - Street 1:1 SAINT VINCENT CIR STE 410
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5409
Mailing Address - Country:US
Mailing Address - Phone:501-762-8056
Mailing Address - Fax:501-781-2490
Practice Address - Street 1:1 SAINT VINCENT CIR STE 410
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5409
Practice Address - Country:US
Practice Address - Phone:501-762-8056
Practice Address - Fax:501-781-2490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR=========OtherIRS