Healthcare Provider Details
I. General information
NPI: 1821281528
Provider Name (Legal Business Name): JOSEPH M. LACAVA, DPM.,PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/26/2007
Last Update Date: 03/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3339 CENTRAL AVE STE.F
HOT SPRINGS AR
71913-6138
US
IV. Provider business mailing address
3339 CENTRAL AVE STE.F
HOT SPRINGS AR
71913-6138
US
V. Phone/Fax
- Phone: 501-321-4844
- Fax: 501-321-0956
- Phone: 501-321-4844
- Fax: 501-321-0956
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | 217 |
| License Number State | AR |
VIII. Authorized Official
Name: DR.
JOSEPH
MICHAEL
LACAVA
Title or Position: PRESIDENT
Credential: DPM
Phone: 501-321-4844