Healthcare Provider Details

I. General information

NPI: 1598960270
Provider Name (Legal Business Name): CIDNEY SCOTT HULETT MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 01/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SAINT VINCENT CIR SUITE 150
LITTLE ROCK AR
72205-5405
US

IV. Provider business mailing address

1 SAINT VINCENT CIR SUITE 150
LITTLE ROCK AR
72205-5405
US

V. Phone/Fax

Practice location:
  • Phone: 501-552-6830
  • Fax: 501-552-4170
Mailing address:
  • Phone: 501-552-6830
  • Fax: 501-552-4170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number246001
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number246001
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: