Healthcare Provider Details

I. General information

NPI: 1255518999
Provider Name (Legal Business Name): THOMAS RICHARD HOBEROCK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2008
Last Update Date: 01/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3213 HWY 392 W
HARRISON AR
72601
US

IV. Provider business mailing address

PO BOX 1286
HARRISON AR
72602-1286
US

V. Phone/Fax

Practice location:
  • Phone: 870-741-7331
  • Fax:
Mailing address:
  • Phone: 870-741-7331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberR2207
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: