MEDICARE: HOT SPRINGS PHYSICAL MEDICINE & REHABILITATION CLINIC PLLC

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
1	208100000X	Physical Medicine & Rehabilitation Physician	C-8261	AR

General Provider Information

NPI Number	:	1568815835
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOT SPRINGS PHYSICAL MEDICINE & REHABILITATION CLINIC PLLC

Provider Business Mailing Address
First Line	:	1635 HIGDON FERRY RD STE A
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6904
Country	:	US
Telephone Number	:	501-525-4785
Fax Number	:	501-525-4794

Provider Business Practice Location Address
First Line	:	1635 HIGDON FERRY RD STE A
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6904
Country	:	US
Telephone Number	:	501-525-4785
Fax Number	:	501-525-4794

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROSS A HARDY
Credential	:	MD
Telephone Number	:	501-525-4785

Provider Enumeration Date	:	07/21/2016
Last Update Date	:	09/16/2016

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