Healthcare Provider Details

I. General information

NPI: 1275464380
Provider Name (Legal Business Name): AUSTIN LEE HUBER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 DAVID ST
CORNING AR
72422-7268
US

IV. Provider business mailing address

3302 E MOORE AVE
SEARCY AR
72143-5099
US

V. Phone/Fax

Practice location:
  • Phone: 870-857-3655
  • Fax: 870-857-3637
Mailing address:
  • Phone: 501-236-0130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberPLMSW
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: