Healthcare Provider Details
I. General information
NPI: 1053692137
Provider Name (Legal Business Name): HOT SPRING COUNTY MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/02/2011
Last Update Date: 09/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1002 SCHNEIDER DR SUITE 102
MALVERN AR
72104-4816
US
IV. Provider business mailing address
1001 SCHNEIDER DR
MALVERN AR
72104-4811
US
V. Phone/Fax
- Phone: 501-332-1012
- Fax: 501-332-7088
- Phone: 501-332-1000
- Fax: 501-332-7395
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHEILA
WILLIAMS
Title or Position: CEO
Credential:
Phone: 501-332-1004