Healthcare Provider Details

I. General information

NPI: 1285614537
Provider Name (Legal Business Name): ROBERT F MCCRARY JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 01/15/2020
Certification Date: 01/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 WRIGHTS ST
HOT SPRINGS AR
71913-6240
US

IV. Provider business mailing address

115 WRIGHTS ST
HOT SPRINGS AR
71913-6240
US

V. Phone/Fax

Practice location:
  • Phone: 501-321-9803
  • Fax: 501-321-0710
Mailing address:
  • Phone: 501-321-9803
  • Fax: 501-321-0710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberC4991
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: