Basic Information
| Provider Information | |||||||||
| NPI: | 1427104025 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ESCOBAR | ||||||||
| FirstName: | GUILLERMO | ||||||||
| MiddleName: | ALEJANDRO | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | ESCOBAR | ||||||||
| OtherFirstName: | GUILLERMO | ||||||||
| OtherMiddleName: | CURN | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4301 W MARKHAM ST | ||||||||
| Address2: | SLOT 520-2 | ||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722057101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016865328 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4301 W MARKHAM ST # 783 | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722057101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016868000 | ||||||||
| FaxNumber: | 5015266562 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2007 | ||||||||
| LastUpdateDate: | 08/07/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 4301092987 | MI | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0129X | 4301092987 | MI | N | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | 390200000X | DR-43891 | CO | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2086S0129X | E-8153 | AR | Y | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
No ID Information.