Healthcare Provider Details
I. General information
NPI: 1962865162
Provider Name (Legal Business Name): DANIEL HESTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/04/2016
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2302 COLLEGE AVE STE 100
CONWAY AR
72034-6297
US
IV. Provider business mailing address
PO BOX 9662
CONWAY AR
72033-9662
US
V. Phone/Fax
- Phone: 501-513-5385
- Fax:
- Phone: 501-852-1363
- Fax: 501-852-1364
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | E-18740 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: