Healthcare Provider Details

I. General information

NPI: 1194543736
Provider Name (Legal Business Name): MEDICAL HEARING ASSOCIATES OF ARKANSAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2024
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5910 C ST
LITTLE ROCK AR
72205-3320
US

IV. Provider business mailing address

5910 C ST
LITTLE ROCK AR
72205-3320
US

V. Phone/Fax

Practice location:
  • Phone: 501-476-3178
  • Fax: 501-246-3202
Mailing address:
  • Phone: 501-476-3178
  • Fax: 501-246-3202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: DAVID BRADLEY DAVIS
Title or Position: OWNER
Credential:
Phone: 501-476-3178