Provider Demographics
NPI:1841395423
Name:STEFANS, VIKKI ANN (MD)
Entity type:Individual
Prefix:DR
First Name:VIKKI
Middle Name:ANN
Last Name:STEFANS
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 1:1 CHILDRENS WAY # 653
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3500
Mailing Address - Country:US
Mailing Address - Phone:501-364-1100
Mailing Address - Fax:501-364-4082
Practice Address - Street 1:1 CHILDRENS WAY # 512-5B
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3500
Practice Address - Country:US
Practice Address - Phone:501-364-4374
Practice Address - Fax:501-364-6829
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARN-72362081P0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARN7236OtherTRICARE
AR113043724Medicaid
TXP8B063040Medicaid
AR12047000000OtherQUALCHOICE
AR51727OtherBCBS
AR113696001Medicaid
AR113696001Medicaid
AR51727Medicare PIN