Healthcare Provider Details

I. General information

NPI: 1538122858
Provider Name (Legal Business Name): WILLIAM R. HURST D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2006
Last Update Date: 01/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 WEST PARKER ROAD SUITE B FIRST CARE - PARKER ROAD
JONESBORO AR
72404
US

IV. Provider business mailing address

P.O. BOX 1331
JONESBORO AR
72403
US

V. Phone/Fax

Practice location:
  • Phone: 870-972-8181
  • Fax: 870-974-7001
Mailing address:
  • Phone: 870-972-8181
  • Fax: 870-974-7001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberN7784
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: