Healthcare Provider Details

I. General information

NPI: 1770540023
Provider Name (Legal Business Name): HUGH G DONNELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 07/06/2023
Certification Date: 07/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2708 RIFE MEDICAL LANE SUITE 130
ROGERS AR
72758-1452
US

IV. Provider business mailing address

2708 RIFE MEDICAL LANE SUITE 130
ROGERS AR
72758-1452
US

V. Phone/Fax

Practice location:
  • Phone: 479-338-5555
  • Fax: 479-338-5533
Mailing address:
  • Phone: 479-338-5555
  • Fax: 479-338-5533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberC7474
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC7474
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC7474
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: