LARRY HENLE WALLER (NPI# 1710996996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710996996 |
| Entity Type | Individual |
| Full Name | LARRY HENLE WALLER |
| Credential | M.D. |
| Practice Address |
500 S University Ave Suite 316 Little Rock AR 72205-5302 |
| Practice Telephone | 5016039600 |
| Practice Fax Number | 5016030042 |
| Mailing Telephone | 5016039600 |
| Mailing Fax Number | 5016030042 |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | E0253 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 125849001 | 05 | |
| TRICARE WPS | 71082800072205AO | 01 | |
| AR | 137315002 | 05 | |
| UNITED HEALTHCARE | 7420056 | 01 | |
| HEALTHSOURCE | 04828 | 01 | |
| QUALCHOICE | 16047000000 | 01 |
| Street Address |
500 S UNIVERSITY AVE SUITE 316 |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72205-5302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083618318 | Tammy Lea Dunn | Specialist | 500 S University Ave, Ste 606, Little Rock, AR 72205-5342 | 2005-05-31 |
| 1043843915 | Jeff Pinto | Nurse Practitioner | 500 S University Ave, Little Rock, AR 72205-5302 | 2020-02-19 |
| 1821534835 | Brittney Denell Lisenbey | Nurse Practitioner | 500 S University Ave, Suite 515, Little Rock, AR 72205-5302 | 2017-01-13 |
| 1245687029 | Arkansas Breast Surgery Corp. | Surgery | 500 S University Ave, Suite 219, Little Rock, AR 72205-5302 | 2016-05-20 |
| 1497128722 | Alexandra Blue Gonzalez | Physician Assistant | 500 S University Ave, Little Rock Dermatology Clinic Suite 301, Little Rock, AR 72205-5302 | 2015-11-09 |
| 1609251842 | Pediatric Physicians Group, Pllc | Pediatrics | 500 S University Ave, Suite 200, Little Rock, AR 72205-5302 | 2015-07-29 |
| 1609260157 | Gabriel M Peal M.d,.,pa | Specialist | 500 S University Ave, Suite 221, Little Rock, AR 72205-5302 | 2015-03-23 |
| 1376947804 | Blood and Cancer Institute of Little Rock | Clinical Medical Laboratory | 500 S University Ave, Suite 808, Little Rock, AR 72205-5302 | 2014-10-13 |
| 1457765182 | Jena Gray | Registered Nurse | 500 S University Ave, Suite 505, Little Rock, AR 72205-5302 | 2014-06-20 |
| 1952723397 | Jesse Davis | Registered Nurse | 500 S University Ave, Ste 505, Little Rock, AR 72205-5302 | 2014-01-18 |
| Find all providers in the same location | ||||
| 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 | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922366863 | Shelly Lorn Gibbs | Obstetrics & Gynecology | 10001 Lile Dr Fl 2, Little Rock, AR 72205-6217 | 2012-04-29 |
| 1467728022 | James Luther Hagler | Obstetrics & Gynecology | 12015 Fairway Dr, Little Rock, AR 72212-3426 | 2012-03-28 |
| 1770747149 | Elizabeth Metzger Paladino | Obstetrics & Gynecology | 9601 Baptist Health Dr Ste 1200, Little Rock, AR 72205-6334 | 2008-07-15 |
| 1669656229 | Leticia A Jones | Obstetrics & Gynecology | 9600 Lile Dr Ste 250, Little Rock, AR 72205-6373 | 2007-12-19 |
| 1649465386 | Estelle Alexis Rutledge | Obstetrics & Gynecology | 38 Villa Vista Loop, Little Rock, AR 72204-6708 | 2007-09-06 |
| 1891996823 | Susan A. Barr | Obstetrics & Gynecology | 5 Saint Vincent Cir Ste 300, Little Rock, AR 72205 | 2007-05-29 |
| 1659498129 | Just for Women Health Center Pa | Obstetrics & Gynecology | 5100 W 12th St, Little Rock, AR 72204-1855 | 2007-03-22 |
| 1588745046 | Rufus Thrower Jr. | Obstetrics & Gynecology | 1601 S University Ave, Little Rock, AR 72204-3601 | 2006-10-18 |
| 1487766986 | Cortez Evan Mcfarland | Obstetrics & Gynecology | 1 St Vincent Cr, #440, Little Rock, AR 72205-5492 | 2006-08-31 |
| 1497717045 | Juan J Roman-lopez | Obstetrics & Gynecology | 4301 W Markham St Slot 793, Little Rock, AR 72205-7101 | 2006-04-06 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72205 |
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| 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.