Healthcare Provider Details

I. General information

NPI: 1275110181
Provider Name (Legal Business Name): HOT SPRINGS INTERNAL MEDICINE CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 07/09/2021
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 EXCHANGE STREET
HOT SPRINGS AR
71901
US

IV. Provider business mailing address

130 LOTUS PL
HOT SPRINGS AR
71901-9220
US

V. Phone/Fax

Practice location:
  • Phone: 501-765-7791
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE LAI
Title or Position: VICE PRESIDENT
Credential: MD
Phone: 501-765-7799