Provider Demographics
NPI:1194161869
Name:PERTZBORN, MATTHEW CHRISTOPHER (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:CHRISTOPHER
Last Name:PERTZBORN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHILDRENS WAY # 512-17
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3591
Mailing Address - Country:US
Mailing Address - Phone:501-364-1006
Mailing Address - Fax:501-364-3930
Practice Address - Street 1:1 CHILDRENS WAY # 512-17
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3591
Practice Address - Country:US
Practice Address - Phone:501-364-1006
Practice Address - Fax:501-364-3930
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME1272192080P0214X
ARE-118422080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology