Healthcare Provider Details

I. General information

NPI: 1285660506
Provider Name (Legal Business Name): HOT SPRINGS CLINIC OF OTOLARYNGOLOGY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 04/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 CARPENTER DAM RD STE N
HOT SPRINGS AR
71901-8282
US

IV. Provider business mailing address

307 CARPENTER DAM RD STE N
HOT SPRINGS AR
71901-8282
US

V. Phone/Fax

Practice location:
  • Phone: 501-624-5422
  • Fax: 501-624-4602
Mailing address:
  • Phone: 501-624-5422
  • Fax: 501-624-4602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: ERIC D MONTE
Title or Position: PRESIDENT
Credential: MD
Phone: 501-624-5422