Provider Demographics
NPI:1710037353
Name:PAUL, ERIC M (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:M
Last Name:PAUL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:9500 KANIS RD
Mailing Address - Street 2:SUITE 501
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6324
Mailing Address - Country:US
Mailing Address - Phone:501-227-9080
Mailing Address - Fax:501-217-2534
Practice Address - Street 1:9500 KANIS RD
Practice Address - Street 2:SUITE 501
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6324
Practice Address - Country:US
Practice Address - Phone:501-227-9080
Practice Address - Fax:501-217-2534
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2013-11-19
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Provider Licenses
StateLicense IDTaxonomies
ARE6539208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR185567001Medicaid
AR5H789Medicare PIN