ALLOPLASTIC RECONSTRUCTION (NPI# 1598049744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598049744 |
| Entity Type | Organization |
| Organization Name | ALLOPLASTIC RECONSTRUCTION |
| Practice Address |
3924 W Markham St Little Rock AR 72205-5528 |
| Practice Telephone | 5012650100 |
| Practice Fax Number | 5012650102 |
| Mailing Telephone | 5012650100 |
| Mailing Fax Number | 5012650102 |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2018-09-26 |
| Authorized Official Name | MR. MICHAEL KACZKOWSKI (PRESIDENT) |
| Authorized Official Telephone | 5012650100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 229N00000X | Anaplastologist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers | ||
| N | 174400000X | Specialist | Other Service Providers | ||
| N | 335E00000X | Prosthetic/Orthotic Supplier | OPP00038 | AR | Suppliers |
| Y | 156FX1700X |
Technician/Technologist Specialization: Ocularist |
Eye and Vision Services Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 220 N Van Buren St, Little Rock, AR 722053650 | 5012650100 | 5012650102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962805812 | Alloplastic Reconstruction | Technician/Technologist | 6 W Ge Patterson Ave, Suite 102, Memphis, TN 38103-6413 | 2014-10-07 |
| Street Address |
3924 W MARKHAM ST |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72205-5528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699957928 | Alloplastic Facial Reconstruction | Durable Medical Equipment & Medical Supplies | 3924 W Markham St, Little Rock, AR 72205-5528 | 2007-11-28 |
| 1417236860 | Michael Kaczkowski | Technician/Technologist | 3924 W Markham St, Little Rock, AR 72205 | 2011-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932719465 | Darleisha Renee Stigall | Behavior Technician | 1210 Aldersdate Rd, Little Rock, AR 72205 | 2020-08-10 |
| 1316563638 | Unknown Amisha | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot #634, University of Arkansas, Little Rock, AR 72205 | 2020-06-23 |
| 1225667272 | Ann-marie Frances Hayre | Student in an Organized Health Care Education/Training Program | 4310 West Markham, Slot 589, Little Rock, AR 72205 | 2020-04-02 |
| 1952930075 | Alexandria Leigh Smith | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot 531, Little Rock, AR 72205 | 2020-04-02 |
| 1093353922 | Phil Fagala | Pharmacist | 614 North Beechwood, Little Rock, AR 72205 | 2019-12-10 |
| 1295391688 | Home To Community Living, Inc | Physical Therapist | 10201 W Markham Street Pulaski, Little Rock, AR 72205 | 2019-05-12 |
| 1669933693 | Sandy Louise Webb | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 530, Little Rock, AR 72205 | 2019-03-31 |
| 1457812828 | Vincent Battafarano | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 602, Little Rock, AR 72205 | 2019-03-28 |
| 1063978922 | Franks Pediatric Occupational Therapy LLC | Occupational Therapist | 5516 C St, Little Rock, AR 72205 | 2019-02-15 |
| 1497210199 | Integrative Counseling Center LLC | Counselor | 10515 W Markham St Ste D3, Little Rock, AR 72205 | 2019-02-06 |
| Find all providers in zip 72205 | ||||
| Taxonomy Code | 156FX1700X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Ocularist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265920813 | Alloplastic Restoration Foundation, Inc. | Technician/Technologist | 220 N Van Buren St, Little Rock, AR 72205-3650 | 2018-04-30 |
| 1417236860 | Michael Kaczkowski | Technician/Technologist | 3924 W Markham St, Little Rock, AR 72205 | 2011-08-16 |
| City | LITTLE ROCK |
| Zip Code | 72205 |
Please comment or provide details below to improve the information on ALLOPLASTIC RECONSTRUCTION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.