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NPI Code Detail

MEDICARE: RUKMIN R HETTIARACHCHY MD

MEDICARE: RUKMIN R HETTIARACHCHY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician35938AZ
2207L00000XAnesthesiology PhysicianE-12058AR

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2116390OTHERMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023085842
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUKMIN R HETTIARACHCHY MD
Provider Business Mailing Address
First Line : 500 S UNIVERSITY AVE STE 500
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-5307
Country : US
Telephone Number : 501-664-4532
Fax Number : 501-663-4335
Provider Business Practice Location Address
First Line : 300 WERNER ST
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71913-6406
Country : US
Telephone Number : 501-664-4532
Fax Number : 501-663-4335
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2006
Last Update Date : 03/17/2020

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Directions to “ RUKMIN R HETTIARACHCHY MD” Practice Location

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