Healthcare Provider Details

I. General information

NPI: 1346878303
Provider Name (Legal Business Name): HOT SPRINGS AMBULATORY SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 03/21/2022
Certification Date: 03/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 SAWTOOTH OAK ST
HOT SPRINGS AR
71901
US

IV. Provider business mailing address

108 N SHACKLEFORD RD
LITTLE ROCK AR
72211-2840
US

V. Phone/Fax

Practice location:
  • Phone: 501-392-9065
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH ANN WADDELL
Title or Position: EXECUTIVE DIR. OF SURGICAL SERVICES
Credential:
Phone: 501-766-1065