Healthcare Provider Details

I. General information

NPI: 1861857658
Provider Name (Legal Business Name): HOT SPRINGS IMAGING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2015
Last Update Date: 06/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 ADCOCK RD. SUITE B
HOT SPRINGS AR
71913-7958
US

IV. Provider business mailing address

120 ADCOCK RD. SUITE B
HOT SPRINGS AR
71913-7958
US

V. Phone/Fax

Practice location:
  • Phone: 501-767-1538
  • Fax:
Mailing address:
  • Phone: 501-767-1538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License NumberPP02145
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVIS W TURNER
Title or Position: VICE PRESIDENT
Credential:
Phone: 615-844-9800