Basic Information
Provider Information
NPI: 1265688733
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BUMPASS
FirstName: DAVID
MiddleName: BENJAMIN
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4301 W MARKHAM ST # 783
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722057101
CountryCode: US
TelephoneNumber: 5016868000
FaxNumber: 5015265148
Practice Location
Address1: 4301 W MARKHAM ST # 531
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722057101
CountryCode: US
TelephoneNumber: 5015267219
FaxNumber: 5015267201
Other Information
ProviderEnumerationDate: 08/14/2008
LastUpdateDate: 06/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XS0117X2013006685MON Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
207X00000XE-9552ARY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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