Healthcare Provider Details

I. General information

NPI: 1093715047
Provider Name (Legal Business Name): ADAM STEFAN STIBICH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3633 CENTRAL AVE STE N
HOT SPRINGS AR
71913-6404
US

IV. Provider business mailing address

3633 CENTRAL AVE STE N
HOT SPRINGS AR
71913-6404
US

V. Phone/Fax

Practice location:
  • Phone: 501-623-6100
  • Fax: 501-623-6187
Mailing address:
  • Phone: 501-623-6100
  • Fax: 501-623-6187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberE2886
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberE2886
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: