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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033197215 NPPES
Arkansas MEDICAID 145157001
Arkansas Other 5L876C207

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