Provider Demographics
NPI:1285780809
Name:HEKMATPOUR, ERIN WARD (MD)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:WARD
Last Name:HEKMATPOUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 AUTUMN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3741
Mailing Address - Country:US
Mailing Address - Phone:501-227-6363
Mailing Address - Fax:303-420-2953
Practice Address - Street 1:904 AUTUMN RD STE 200
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3741
Practice Address - Country:US
Practice Address - Phone:501-227-6363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO46702207Q00000X
ARE-11824207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO11787279Medicaid
CO11787279Medicaid