Healthcare Provider Details

I. General information

NPI: 1811436124
Provider Name (Legal Business Name): JOHN R PACE, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2017
Last Update Date: 02/05/2020
Certification Date: 02/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 ADCOCK RD SUITE C
HOT SPRINGS AR
71913-7958
US

IV. Provider business mailing address

1661 AIRPORT RD SUITE D
HOT SPRINGS AR
71913-7951
US

V. Phone/Fax

Practice location:
  • Phone: 501-651-4488
  • Fax: 501-651-4490
Mailing address:
  • Phone: 501-625-7500
  • Fax: 501-625-7777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN ROBERT PACE
Title or Position: OWNER
Credential:
Phone: 501-651-4488