Organization Active NPI

Robert a. Council, Jr., MD, PA

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Benton, AR
National Provider Identifier
1104041292
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Emergency Medicine) PhysicianTaxonomy code 207PE0005X
Legal business name
ROBERT A. COUNCIL, JR., MD, PA
Practice address
1 Medical Park Dr
Benton, AR 72015-3353
Phone
(501) 776-6901
Fax
(501) 776-6908
NPI assigned
Apr 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Robert A. Council Jr., M.D.
Title
Owner
Phone
(501) 776-5070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Emergency Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207PE0005X Primary

Addresses

Primary practice location

1 Medical Park Dr
Benton, AR 72015-3353

Mailing address

PO Box 9150
Paducah, KY 42002-9150
Phone (270) 744-9600

Other identifiers 1

IdentifierTypeStateIssuer
E2086OtherARELECTRONIC SUBMITTER

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253664000000",
    "number": "1104041292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9150",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420029150",
            "telephone_number": "270-744-9600",
            "fax_number": "270-744-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK DR",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153353",
            "telephone_number": "501-776-6901",
            "fax_number": "501-776-6908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT A. COUNCIL, JR., MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2009-09-23",
        "status": "A",
        "authorized_official_last_name": "COUNCIL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-776-5070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207PE0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELECTRONIC SUBMITTER",
            "identifier": "E2086",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.