Healthcare Provider Details

I. General information

NPI: 1730194556
Provider Name (Legal Business Name): HOT SPRINGS RADIATION ONCOLOGY, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 09/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 HIGDON FERRY RD
HOT SPRINGS AR
71913-6419
US

IV. Provider business mailing address

PO BOX 22148
HOT SPRINGS AR
71903-2148
US

V. Phone/Fax

Practice location:
  • Phone: 501-622-2100
  • Fax: 501-622-4676
Mailing address:
  • Phone: 501-622-1913
  • Fax: 601-622-4676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: NICOLA JANE PRUITT
Title or Position: OFFICE MANAGER
Credential:
Phone: 501-622-1913