Provider Demographics
NPI:1225890353
Name:CAPSTONE PSYCHIATRY LLC
Entity type:Organization
Organization Name:CAPSTONE PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESMAEILPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-441-4980
Mailing Address - Street 1:500 S UNIVERSITY AVE STE 606
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5308
Mailing Address - Country:US
Mailing Address - Phone:501-441-4980
Mailing Address - Fax:
Practice Address - Street 1:500 S UNIVERSITY AVE STE 606
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5308
Practice Address - Country:US
Practice Address - Phone:501-441-4980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1457679011Medicaid
AR1740424522Medicaid
AR1326350885Medicaid
AR1093005761Medicaid