Healthcare Provider Details

I. General information

NPI: 1043100944
Provider Name (Legal Business Name): HEATHER HAMMONDS MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2025
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 RESTORE DR
MOUNTAIN HOME AR
72653-4641
US

IV. Provider business mailing address

103 RESTORE DR
MOUNTAIN HOME AR
72653-4641
US

V. Phone/Fax

Practice location:
  • Phone: 870-232-5309
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: STEPH RHOADES
Title or Position: CLINIC MANAGER
Credential:
Phone: 870-232-5309