Healthcare Provider Details

I. General information

NPI: 1568815835
Provider Name (Legal Business Name): HOT SPRINGS PHYSICAL MEDICINE & REHABILITATION CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2016
Last Update Date: 09/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 HIGDON FERRY RD STE A
HOT SPRINGS AR
71913-6904
US

IV. Provider business mailing address

1635 HIGDON FERRY RD STE A
HOT SPRINGS AR
71913-6904
US

V. Phone/Fax

Practice location:
  • Phone: 501-525-4785
  • Fax: 501-525-4794
Mailing address:
  • Phone: 501-525-4785
  • Fax: 501-525-4794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberC-8261
License Number StateAR

VIII. Authorized Official

Name: ROSS A HARDY
Title or Position: PRESIDENT
Credential: MD
Phone: 501-525-4785