Provider Demographics
NPI:1730172099
Name:VELEZ, LOUIS DUANE (MD)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:DUANE
Last Name:VELEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4202 S UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-7841
Mailing Address - Country:US
Mailing Address - Phone:501-562-4838
Mailing Address - Fax:501-562-1958
Practice Address - Street 1:4202 S UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-7841
Practice Address - Country:US
Practice Address - Phone:501-562-4838
Practice Address - Fax:501-562-1958
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC5103207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR104839001Medicaid
AR2920057OtherUNITED HEALTHCARE
AR55417OtherBLUE CROSS BLUE SHIELD
AR13469000000OtherQUALCHOICE
AR13469000000OtherQUALCHOICE
ARE07126Medicare UPIN