MEDICARE: DR. DAVID RANDAL HUNDLEY 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
1	207RC0000X	Cardiovascular Disease Physician	N6778	AR
2	207RI0011X	Interventional Cardiology Physician	N6778	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	89-T031	OTHER	AR	MALP INS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760580245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID RANDAL HUNDLEY MD

Provider Business Mailing Address
First Line	:	2423 N FILLMORE ST
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72207-3612
Country	:	US
Telephone Number	:	501-350-2030
Fax Number	:	501-421-0105

Provider Business Practice Location Address
First Line	:	601 S GAINES ST
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72201-4007
Country	:	US
Telephone Number	:	501-378-5623
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	09/04/2014

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Directions to “ DR. DAVID RANDAL HUNDLEY MD” Practice Location

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