Healthcare Provider Details

I. General information

NPI: 1538948484
Provider Name (Legal Business Name): KALLI MARIE SASSAMAN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2023
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 AIRPORT RD STE F
HOT SPRINGS AR
71913-8184
US

IV. Provider business mailing address

1661 AIRPORT RD STE F
HOT SPRINGS AR
71913-8184
US

V. Phone/Fax

Practice location:
  • Phone: 501-651-4300
  • Fax:
Mailing address:
  • Phone: 501-651-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: