Schock, Ethan J
Schock, Ethan J is an individual health care provider with primary practice located at 800 Fair Park Blvd , Little Rock AR 72204. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Schock, Ethan J can be contacted via phone (501) 663-3647.Contact Information
Primary practice address
800 Fair Park Blvd
Little Rock AR 72204
Phone: (501) 663-3647
Fax: (501) 666-9653
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | E-2961 | Arkansas |
Profile Details
| NPI number | 1033197215 |
|---|---|
| LBN Legal business name | Schock, Ethan J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 6th, 2006 |
| Last updated | Jul 6th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033197215 | NPPES |
| Arkansas | MEDICAID | 145157001 | |
| Arkansas | Other | 5L876C207 |
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