1346898467 NPI number — CEM CENGIZ MD

Table of content: CEM CENGIZ MD (NPI 1346898467)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346898467 NPI number — CEM CENGIZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CENGIZ
Provider First Name:
CEM
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346898467
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/09/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 251420
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITTLE ROCK
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72225-1420
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-686-8000
Provider Business Mailing Address Fax Number:
501-526-5148

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4110 OUTPATIENT CIRCLE
Provider Second Line Business Practice Location Address:
THIRD FLOOR
Provider Business Practice Location Address City Name:
LITTLE ROCK
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-603-1900
Provider Business Practice Location Address Fax Number:
501-526-4596
Provider Enumeration Date:
09/02/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  E-12515 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RG0100X , with the licence number: E-12515 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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