Healthcare Provider Details

I. General information

NPI: 1043342215
Provider Name (Legal Business Name): ARCHA ELIZABETH SCHMELZ OTR STATE OF ARKANSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 CORDOBA CTR DR
HOT SPRINGS VILLAGE AR
71909
US

IV. Provider business mailing address

140 CORDOBA CTR DR
HOT SPRINGS VILLAGE AR
71909
US

V. Phone/Fax

Practice location:
  • Phone: 501-922-1618
  • Fax: 501-922-9735
Mailing address:
  • Phone: 501-922-1618
  • Fax: 501-922-9735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberOTR2102
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: