Active NPI 1922327485 Individual Practitioner Male Practitioner

Dr. Henry C. Wallace , MD

Orthopaedic Surgery • Clinton, AR

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Henry Wallace, MD is a certified Orthopaedic Surgery practicing in Clinton, AR. With approximately 21 years of clinical experience since graduating from University Of Arkansas College Of Medicine in 2005, Dr. Wallace delivers high-quality medical care to the local community at 2526 HIGHWAY 65 S STE 205.

Dr. Wallace is affiliated with Orthoarkansas Pa and accepts Medicare assignment.

Frequently performed procedures and clinical services include injection, methylprednisolone acetate, 1 mg, established patient outpatient office visit, aspiration and/or injection of fluid from large joint. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

2526 Highway 65 S Ste 205

Clinton, AR 720316678

Telephone 5015003500

Associated Practice Facility / Clinic

🏢 Orthoarkansas, Pa Facility NPI 1952336869

Medicare Profile & Education

Medical School

University Of Arkansas College Of Medicine

Graduation Year

2005

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Orthopaedic Surgery in Clinton, AR

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

21 Yrs Matches City Avg

City Avg: 21.0 Yrs

State Avg: 29.4 Yrs

Regional Practice Density

1 Specialists

Practicing in Clinton, AR (222 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

72.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wallace (21 Years) 21 Yrs

Clinton Specialty Average (21.0 Years) 21.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J1010 Injection, methylprednisolone acetate, 1 mg	58,078	425	$0.50	$0.13
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,169	660	$300.00	$115.07
20610 Aspiration and/or injection of fluid from large joint	689	426	$226.50	$66.40
J1030 Injection, methylprednisolone acetate, 40 mg	336	118	$20.00	$6.34
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	280	280	$460.00	$149.34
73564 X-ray of knee, 4 or more views	146	116	$160.00	$40.00
20551 Injection into tendon at attachment to bone or muscle	96	67	$170.00	$47.58
73030 X-ray of shoulder, minimum of 2 views	90	70	$120.00	$30.21
73130 X-ray of hand, minimum of 3 views	52	39	$119.42	$32.06
27447 Replacement of knee joint, both sides of knee	49	45	$4130.00	$1119.01
20985 Computer-assisted surgery for muscle and bone procedure	48	44	$420.00	$126.76
73502 X-ray of hip, 2-3 views	46	43	$100.00	$41.15
20605 Aspiration and/or injection of medium joint or joint capsule	44	37	$168.64	$46.73
73562 X-ray of knee, 3 views	38	34	$140.00	$35.33
73110 X-ray of wrist, minimum of 3 views	34	20	$140.00	$35.60
64721 Release and/or relocation of hand nerve	29	28	$1250.69	$368.56
73630 X-ray of foot, minimum of 3 views	28	19	$120.00	$29.64
73610 X-ray of ankle, minimum of 3 views	27	15	$130.00	$31.56
20600 Aspiration and/or injection of fluid from small joint	20	17	$161.00	$41.73
73070 X-ray of elbow, 2 views	19	15	$110.00	$25.37
26055 Incision of tendon covering	19	16	$1480.00	$205.76
23472 Prosthetic repair of shoulder joint, total shoulder	18	18	$4050.00	$1275.63
20550 Injection into tendon or ligament	18	17	$170.00	$52.23

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J1030 Injection, methylprednisolone acetate, 40 mg	880	250	$20.00	$7.44
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	816	435	$300.00	$116.41
20610 Aspiration and/or injection of fluid from large joint	484	282	$218.47	$65.25
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	214	214	$460.00	$150.73
J1040 Injection, methylprednisolone acetate, 80 mg	208	146	$40.00	$12.13
73564 X-ray of knee, 4 or more views	94	76	$157.66	$40.44
73030 X-ray of shoulder, minimum of 2 views	71	57	$115.49	$29.31
20985 Computer-assisted surgery for muscle and bone procedure	58	55	$420.00	$129.76
27447 Replacement of knee joint, both sides of knee	57	55	$4202.25	$1161.63
20551 Injection into tendon at attachment to bone or muscle	48	40	$170.00	$47.36
73502 X-ray of hip, 2-3 views	47	41	$94.04	$38.07
73130 X-ray of hand, minimum of 3 views	30	24	$114.67	$29.22
64721 Release and/or relocation of hand nerve	28	22	$1170.00	$364.28
73562 X-ray of knee, 3 views	28	24	$140.00	$35.73
73110 X-ray of wrist, minimum of 3 views	27	17	$140.00	$35.97
20605 Aspiration and/or injection of medium joint or joint capsule	22	21	$184.55	$48.95
73630 X-ray of foot, minimum of 3 views	21	14	$120.00	$30.22
23472 Prosthetic repair of shoulder joint, total shoulder	20	19	$4050.00	$1249.06
26055 Incision of tendon covering	20	16	$1480.00	$216.43
20550 Injection into tendon or ligament	18	14	$170.00	$49.32
20600 Aspiration and/or injection of fluid from small joint	14	13	$200.00	$52.84

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	754	438	$300.00	$116.31
J1040 Injection, methylprednisolone acetate, 80 mg	585	266	$39.86	$11.01
20610 Aspiration and/or injection of fluid from large joint	418	261	$219.62	$65.33
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	188	188	$460.00	$151.76
73564 X-ray of knee, 4 or more views	117	88	$159.91	$40.86
J1030 Injection, methylprednisolone acetate, 40 mg	103	57	$20.00	$6.41
27447 Replacement of knee joint, both sides of knee	73	71	$4101.71	$1153.05
73030 X-ray of shoulder, minimum of 2 views	69	52	$117.68	$29.96
20985 Computer-assisted surgery for muscle and bone procedure	66	64	$420.00	$130.59
20551 Injection into tendon at attachment to bone or muscle	46	40	$170.00	$49.07
26055 Incision of tendon covering	39	32	$1480.00	$217.05
73130 X-ray of hand, minimum of 3 views	37	27	$119.19	$32.05
73110 X-ray of wrist, minimum of 3 views	35	23	$134.29	$33.89
73502 X-ray of hip, 2-3 views	33	28	$100.00	$41.56
64721 Release and/or relocation of hand nerve	29	26	$1170.00	$322.70
20605 Aspiration and/or injection of medium joint or joint capsule	26	21	$183.08	$51.24
20550 Injection into tendon or ligament	23	20	$170.00	$47.85
20600 Aspiration and/or injection of fluid from small joint	17	11	$164.71	$35.00
73610 X-ray of ankle, minimum of 3 views	16	12	$130.00	$32.68
23472 Prosthetic repair of shoulder joint, total shoulder	11	11	$4050.00	$1306.90

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	726	421	$300.00	$117.88
J1040 Injection, methylprednisolone acetate, 80 mg	600	265	$40.00	$10.57
20610 Aspiration and/or injection of fluid from large joint	463	284	$226.54	$66.76
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	250	250	$460.00	$154.01
73564 X-ray of knee, 4 or more views	127	95	$158.27	$40.04
J1030 Injection, methylprednisolone acetate, 40 mg	102	55	$20.00	$5.64
99213 Established patient office or other outpatient visit, typically 15 minutes	73	69	$210.00	$82.65
73030 X-ray of shoulder, minimum of 2 views	58	44	$120.00	$30.25
20551 Injection into tendon at attachment to bone or muscle	50	42	$170.00	$42.58
27447 Replacement of knee joint, both sides of knee	47	47	$4042.13	$1141.67
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	47	21	$20.00	$1.20
64721 Release and/or relocation of hand nerve	43	38	$1170.00	$344.08
73110 X-ray of wrist, minimum of 3 views	43	25	$140.00	$35.52
26055 Incision of tendon covering	38	32	$1480.00	$204.66
73502 X-ray of hip, 2-3 views	32	31	$97.81	$40.14
73130 X-ray of hand, minimum of 3 views	27	22	$117.78	$31.37
23472 Prosthetic repair of shoulder joint, total shoulder	13	13	$4050.00	$1322.58
29823 Removal of extensive shoulder joint tissue using an endoscope	13	13	$2500.00	$270.22
20985 Computer-assisted surgery for muscle and bone procedure	13	13	$403.85	$132.85
20550 Injection into tendon or ligament	12	11	$170.00	$51.27
23412 Repair of chronic torn shoulder rotator cuff	12	12	$2540.00	$776.36
Q4010 Cast supplies, short arm cast, adult (11 years +), fiberglass	12	12	$50.00	$20.40
64718 Release and/or relocation of elbow nerve	11	11	$1620.00	$542.81
27130 Replacement of thigh bone and hip joint with prosthesis	11	11	$3850.00	$1172.77

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,002	556	$210.00	$69.62
J1040 Injection, methylprednisolone acetate, 80 mg	713	312	$40.00	$11.52
20610 Aspiration and/or injection of fluid from large joint	561	312	$214.55	$63.48
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	209	209	$460.00	$152.30
73564 X-ray of knee, 4 or more views	129	98	$160.00	$39.31
J1030 Injection, methylprednisolone acetate, 40 mg	92	66	$20.00	$6.08
73030 X-ray of shoulder, minimum of 2 views	73	56	$120.00	$29.76
20551 Injection into tendon at attachment to bone or muscle	71	53	$170.00	$47.93
73110 X-ray of wrist, minimum of 3 views	56	32	$140.00	$34.73
27447 Replacement of knee joint, both sides of knee	55	54	$4279.75	$1274.32
64721 Release and/or relocation of hand nerve	45	42	$1170.00	$351.69
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	40	40	$300.00	$102.03
73130 X-ray of hand, minimum of 3 views	37	25	$118.38	$30.89
20605 Aspiration and/or injection of medium joint or joint capsule	36	32	$155.56	$44.26
26055 Incision of tendon covering	33	25	$1480.00	$224.50
73502 X-ray of hip, 2-3 views	29	27	$100.00	$40.54
29823 Removal of extensive shoulder joint tissue using an endoscope	16	16	$2500.00	$303.20
20550 Injection into tendon or ligament	16	15	$170.00	$48.38
73610 X-ray of ankle, minimum of 3 views	16	11	$130.00	$31.36
J7326 Hyaluronan or derivative, gel-one, for intra-articular injection, per dose	15	11	$1275.00	$1161.06
64718 Release and/or relocation of elbow nerve	13	13	$1620.00	$555.51

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,274	666	$210.00	$68.23
J1040 Injection, methylprednisolone acetate, 80 mg	879	421	$40.00	$12.07
20610 Aspiration and/or injection of fluid from large joint	657	384	$212.69	$61.19
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	244	244	$460.00	$152.08
73564 X-ray of knee, 4 or more views	159	132	$154.47	$35.69
20551 Injection into tendon at attachment to bone or muscle	136	90	$170.00	$45.90
J1030 Injection, methylprednisolone acetate, 40 mg	124	79	$20.00	$6.27
73030 X-ray of shoulder, minimum of 2 views	94	77	$120.00	$27.16
27447 Replacement of knee joint, both sides of knee	70	67	$4100.50	$1231.88
73110 X-ray of wrist, minimum of 3 views	60	45	$140.00	$32.74
64721 Release and/or relocation of hand nerve	52	47	$1170.00	$291.53
73130 X-ray of hand, minimum of 3 views	41	32	$112.68	$27.85
73502 X-ray of hip, 2-3 views	36	32	$90.28	$34.75
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	36	36	$300.00	$101.45
26055 Incision of tendon covering	33	25	$1480.00	$234.31
29823 Removal of extensive shoulder joint tissue using an endoscope	27	27	$2500.00	$287.35
20605 Aspiration and/or injection of medium joint or joint capsule	24	23	$157.50	$40.12
64450 Injection of anesthetic agent, other peripheral nerve or branch	23	21	$220.00	$20.05
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	22	22	$300.00	$93.39
73562 X-ray of knee, 3 views	20	17	$140.00	$33.41
64718 Release and/or relocation of elbow nerve	19	19	$1620.00	$536.04
25447 Removal of bone joints between wrist and fingers	18	18	$2280.00	$759.74
73610 X-ray of ankle, minimum of 3 views	17	12	$130.00	$29.92
73070 X-ray of elbow, 2 views	17	12	$105.88	$23.24
29881 Removal of knee cartilage using an endoscope	17	17	$1680.00	$489.28
73630 X-ray of foot, minimum of 3 views	16	13	$120.00	$28.05
J7326 Hyaluronan or derivative, gel-one, for intra-articular injection, per dose	16	11	$1200.00	$982.19
23412 Repair of chronic torn shoulder rotator cuff	15	15	$2540.00	$796.20
23430 Anchoring of biceps tendon	14	14	$2060.00	$486.57
73501 X-ray of hip with pelvis, 1 view	14	14	$50.00	$14.48
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	13	13	$580.00	$192.75
27130 Replacement of thigh bone and hip joint with prosthesis	12	12	$3850.00	$1273.10
20600 Aspiration and/or injection of fluid from small joint	12	11	$151.67	$39.62
20550 Injection into tendon or ligament	11	11	$185.45	$38.36

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,510	810	$210.00	$67.24
J1040 Injection, methylprednisolone acetate, 80 mg	1,281	565	$40.00	$12.91
20610 Aspiration and/or injection of fluid from large joint	960	513	$214.63	$60.37
J7325 Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg	913	11	$38.00	$11.86
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	408	408	$460.00	$150.76
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	384	303	$300.00	$98.72
73564 X-ray of knee, 4 or more views	205	172	$160.78	$35.35
20551 Injection into tendon at attachment to bone or muscle	189	128	$170.00	$52.80
J1030 Injection, methylprednisolone acetate, 40 mg	173	114	$20.00	$6.53
73030 X-ray of shoulder, minimum of 2 views	119	98	$119.33	$26.14
73110 X-ray of wrist, minimum of 3 views	82	49	$138.05	$30.73
27447 Replacement of knee joint, both sides of knee	69	66	$4189.68	$1269.78
73502 X-ray of hip, 2-3 views	67	59	$98.96	$36.23
73562 X-ray of knee, 3 views	57	50	$140.00	$31.43
73130 X-ray of hand, minimum of 3 views	54	41	$120.00	$28.02
64721 Release and/or relocation of hand nerve	47	40	$1194.89	$312.18
73610 X-ray of ankle, minimum of 3 views	46	28	$128.04	$26.79
20605 Aspiration and/or injection of medium joint or joint capsule	43	35	$149.77	$41.44
73630 X-ray of foot, minimum of 3 views	42	23	$120.00	$26.25
26055 Incision of tendon covering	30	26	$1480.00	$240.39
64450 Injection of anesthetic agent, other peripheral nerve or branch	30	29	$227.33	$21.77
73070 X-ray of elbow, 2 views	25	16	$110.40	$24.27
64718 Release and/or relocation of elbow nerve	24	22	$1620.00	$544.26
20550 Injection into tendon or ligament	19	17	$170.00	$41.04
20600 Aspiration and/or injection of fluid from small joint	17	14	$164.71	$35.86
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	16	16	$580.00	$191.76
29125 Application of nonmoveable forearm to hand splint	12	11	$180.00	$58.99
29823 Removal of extensive shoulder joint tissue using an endoscope	12	12	$2500.00	$253.35
73565 X-ray of both knees while standing	11	11	$130.00	$31.72

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,858	928	$210.00	$66.79
J1040 Injection, methylprednisolone acetate, 80 mg	1,252	556	$39.97	$10.94
J7325 Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg	1,152	16	$38.00	$12.40
20610 Aspiration and/or injection of fluid from large joint	935	518	$217.75	$61.23
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	355	355	$300.00	$98.52
73564 X-ray of knee, 4 or more views	199	160	$160.80	$35.42
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	152	152	$460.00	$150.25
20551 Injection into tendon at attachment to bone or muscle	143	105	$170.00	$54.06
J1030 Injection, methylprednisolone acetate, 40 mg	139	102	$20.00	$5.61
73030 X-ray of shoulder, minimum of 2 views	117	102	$120.00	$25.82
73110 X-ray of wrist, minimum of 3 views	94	54	$138.94	$30.37
27447 Replacement of knee joint, both sides of knee	93	89	$4130.00	$1251.57
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	80	76	$300.00	$97.73
73562 X-ray of knee, 3 views	70	65	$140.00	$31.66
73502 X-ray of hip, 2-3 views	63	58	$95.56	$35.07
20605 Aspiration and/or injection of medium joint or joint capsule	53	44	$153.21	$41.49
64721 Release and/or relocation of hand nerve	52	47	$1192.50	$320.57
73610 X-ray of ankle, minimum of 3 views	48	29	$130.00	$27.94
26055 Incision of tendon covering	41	31	$1480.00	$214.80
73630 X-ray of foot, minimum of 3 views	33	21	$120.00	$25.76
20550 Injection into tendon or ligament	29	25	$181.72	$41.16
73130 X-ray of hand, minimum of 3 views	29	25	$120.00	$26.64
23412 Repair of chronic torn shoulder rotator cuff	21	21	$2540.00	$781.36
73560 X-ray of knee, 1-2 views	19	15	$120.00	$27.24
73070 X-ray of elbow, 2 views	19	16	$110.00	$24.15
64718 Release and/or relocation of elbow nerve	19	17	$1620.00	$538.89
73060 X-ray of upper arm, minimum of 2 views	18	11	$106.11	$24.72
29823 Removal of extensive shoulder joint tissue using an endoscope	17	17	$2500.00	$301.17
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	17	17	$580.00	$190.54
72170 X-ray of pelvis, 1-2 views	14	13	$105.00	$26.82
73140 X-ray of finger, minimum of 2 views	14	11	$107.14	$24.77
29881 Removal of knee cartilage using an endoscope	13	13	$1680.00	$495.29
27130 Replacement of thigh bone and hip joint with prosthesis	12	12	$3850.00	$1251.99

Medical Specialties & State Licenses

CMS Verified: 2026-06-01

Orthopaedic Surgery Primary Specialty

NUCC Taxonomy Code: 207X00000X

State License TX N4831

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

188382001 (AR)

Commercial Insurance / Payer ID Npi

1922327485 (AR)

Hospital & Practice Group Affiliations

Orthoarkansas Pa

301 Southridge Blvd, Heber Springs, AR 725438872

Phone: 5015003500

Secondary Practice Locations

301 Southridge Blvd Ste A

Heber Springs, AR 72543

Phone: 5012060176

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

Dr. Kirk Reynolds , MD

Orthopaedic Surgery - Sports Medicine

NPI 1013118025

Doctor of Medicine (M.D.)

Lauren Rainwater , PA-C

Physician Assistant - Medical

NPI 1043776099

Physician Assistant (Certified)

Lynn Sardinha , FNP-BC

Nurse Practitioner - Family

NPI 1063908713

Family Nurse Practitioner (Board Certified)

Meagan Celsor

Nurse Practitioner - Family

NPI 1104492255

Tiffany Weston

Physical Therapist

NPI 1104522069

Lauren Schiller , APRN

Nurse Practitioner - Family

NPI 1104564186

Advanced Practice Registered Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events

📍

Updated Practice Location June 01, 2026

Registered at 2526 HIGHWAY 65 S STE 205, CLINTON, AR 720316678 (Tel: 5015003500)

📍

Updated Practice Location January 11, 2019

Registered at 301 SOUTHRIDGE BLVD STE A, HEBER SPRINGS, AR 72543 (Tel: 5012060176)

📍

Updated Business Mailing Address January 11, 2019

Registered at 800 FAIR PARK BLVD, LITTLE ROCK, AR 722041720 (Tel: 5016046900)

✅

NPI Profile Active February 03, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location February 03, 2016

Registered at 301 SOUTHRIDGE BLVD STE A, HEBER SPRINGS, AR 725438872 (Tel: 5012060176)

📍

Updated Business Mailing Address February 03, 2016

Registered at 10301 KANIS RD, LITTLE ROCK, AR 722056205 (Tel: 5016046900)

👤

Provider Name / Credentials Updated February 03, 2016

Recorded as HENRY WALLACE, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 03, 2016

Orthopaedic Surgery (License #N4831 in TX)

🟢

Initial NPI Registration & Enumeration May 24, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1922327485

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: May 24, 2010

Last Update: June 01, 2026

Sole Proprietor: No

Update or Correct Profile

Mailing Address

800 Fair Park Blvd

Little Rock, AR 722041720

Phone: 5014048007

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.