Healthcare Provider Details

I. General information

NPI: 1285374892
Provider Name (Legal Business Name): HONG MAI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 ROGERS AVE
FORT SMITH AR
72903-4100
US

IV. Provider business mailing address

7301 ROGERS AVE
FORT SMITH AR
72903-4100
US

V. Phone/Fax

Practice location:
  • Phone: 479-314-6000
  • Fax: 479-314-4705
Mailing address:
  • Phone: 479-314-6000
  • Fax: 479-314-4705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number45804
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: