Healthcare Provider Details

I. General information

NPI: 1497336572
Provider Name (Legal Business Name): HENLEY PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 04/19/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3604 CENTRAL AVE STE B
HOT SPRINGS AR
71913-6458
US

IV. Provider business mailing address

106 E MATLOCK CT
HOT SPRINGS AR
71901-8319
US

V. Phone/Fax

Practice location:
  • Phone: 501-276-1830
  • Fax:
Mailing address:
  • Phone: 501-276-1830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ZANE ADAM HENLEY
Title or Position: OWNER
Credential: MD
Phone: 501-276-1830