Healthcare Provider Details

I. General information

NPI: 1811598519
Provider Name (Legal Business Name): ADAM TRISTAN BELLCOCK
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2020
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 AIRPORT RD
HOT SPRINGS AR
71913-4060
US

IV. Provider business mailing address

48 BLUE MOUNTAIN DR
MAUMELLE AR
72113-6354
US

V. Phone/Fax

Practice location:
  • Phone: 501-623-2650
  • Fax: 501-623-3704
Mailing address:
  • Phone: 501-607-3269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD14621
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: