Healthcare Provider Details

I. General information

NPI: 1568082840
Provider Name (Legal Business Name): HOT SPRINGS HEART AND VASCULAR CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2020
Last Update Date: 06/02/2020
Certification Date: 06/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 CRACKER BOX LN
HOT SPRINGS NATIONAL PARK AR
71913-5418
US

IV. Provider business mailing address

312 LONG ISLAND DR
HOT SPRINGS AR
71913-9636
US

V. Phone/Fax

Practice location:
  • Phone: 501-767-4278
  • Fax: 501-767-4328
Mailing address:
  • Phone: 501-622-7691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY TAUTH
Title or Position: OWNER
Credential:
Phone: 501-622-7691