Healthcare Provider Details

I. General information

NPI: 1366684391
Provider Name (Legal Business Name): SARAH BETH HARDY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2009
Last Update Date: 12/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 MALVERN AVE
HOT SPRINGS AR
71901-7752
US

IV. Provider business mailing address

1920 MALVERN AVE
HOT SPRINGS AR
71901-7752
US

V. Phone/Fax

Practice location:
  • Phone: 501-321-1314
  • Fax: 501-321-1810
Mailing address:
  • Phone: 501-321-1314
  • Fax: 501-321-1810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE-9522
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number24911
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: