Provider Demographics
NPI:1235248246
Name:PIPPENGER, MARK ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ANTHONY
Last Name:PIPPENGER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11001 EXECUTIVE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4393
Mailing Address - Country:US
Mailing Address - Phone:501-404-3785
Mailing Address - Fax:501-404-3789
Practice Address - Street 1:3201 SPRINGHILL DR STE 490A
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2910
Practice Address - Country:US
Practice Address - Phone:501-202-3815
Practice Address - Fax:501-202-3835
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE-30212084B0040X, 2084N0400X
NC94003222084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & Neuropsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR145071001Medicaid
AR145071001Medicaid