Healthcare Provider Details

I. General information

NPI: 1104842814
Provider Name (Legal Business Name): JOSEPH M. LACAVA DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3339 CENTRAL AVE SUITE F
HOT SPRINGS AR
71913-6138
US

IV. Provider business mailing address

3339 CENTRAL AVE SUITE F
HOT SPRINGS AR
71913-6138
US

V. Phone/Fax

Practice location:
  • Phone: 501-321-4844
  • Fax: 501-321-0956
Mailing address:
  • Phone: 501-321-4844
  • Fax: 501-321-0956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number217
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: