Provider Demographics
NPI:1871585752
Name:NGUYEN, LARRY L (MD)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:L
Last Name:NGUYEN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 NORTHSHORE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72118-5297
Mailing Address - Country:US
Mailing Address - Phone:501-663-6455
Mailing Address - Fax:501-663-4877
Practice Address - Street 1:5220 NORTHSHORE DR
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72118-5297
Practice Address - Country:US
Practice Address - Phone:501-663-6455
Practice Address - Fax:501-663-4877
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-1563207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR133451001Medicaid
ARG63150Medicare UPIN
AR0465700001Medicare NSC
AR5K680C201Medicare PIN
AR133451001Medicaid