Healthcare Provider Details

I. General information

NPI: 1215341201
Provider Name (Legal Business Name): HOT SPRINGS SURGERY CLINIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 06/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11001 EXECUTIVE CENTER DR SUITE 200
LITTLE ROCK AR
72211-4316
US

IV. Provider business mailing address

5342 ESTATE OFFICE DR #1
MEMPHIS TN
38119-3624
US

V. Phone/Fax

Practice location:
  • Phone: 501-812-7800
  • Fax: 501-812-2707
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMES W CAMPBELL
Title or Position: MD
Credential: MD
Phone: 501-624-5700