Provider Demographics
NPI:1588765796
Name:GREENWOOD, DENISE ROCHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:ROCHELLE
Last Name:GREENWOOD
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 1:3724 HILL RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-4144
Mailing Address - Country:US
Mailing Address - Phone:501-296-9100
Mailing Address - Fax:501-296-9102
Practice Address - Street 1:5600 W MARKHAM ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3327
Practice Address - Country:US
Practice Address - Phone:501-296-9100
Practice Address - Fax:501-296-9102
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE0176208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5K099Medicare ID - Type Unspecified
ARF92750Medicare UPIN