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General NPI Number Information
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NPI Number | 1033110556
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Entity Type | Individual
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Provider Name | SAMUEL W VALLERY MD
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Gender | Male
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 09/09/2020
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Provider Practice Location Address
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Address Line | 2212 MALVERN AVE SUITE 8
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City | HOT SPRINGS
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State | AR
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Zip | 71901-8038
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Country | US
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Telephone | 501-609-2300
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Fax | 501-609-2301
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Provider Business Mailing Address
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Address Line | 704 W GROVE ST STE 1
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City | EL DORADO
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State | AR
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Zip | 71730-4469
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Country | US
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Telephone | 870-863-2368
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Fax | 870-875-6233
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | E0503
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License Number State | AR
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