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General NPI Number Information
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NPI Number | 1164752994
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Entity Type | Organization
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Legal Business Name | CHI ST. VINCENT MEDICAL GROUP HOT SPRINGS
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Dates
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Enumeration Date | 12/29/2009
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Last Update Date | 03/02/2020
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Provider Practice Location Address
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Address Line | 320 LUZERNE ST
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City | MOUNT IDA
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State | AR
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Zip | 71957-9437
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Country | US
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Telephone | 870-867-2175
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Fax | 870-867-4050
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Provider Business Mailing Address
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Address Line | PO BOX 21850
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City | HOT SPRINGS
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State | AR
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Zip | 71903-1850
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Country | US
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Telephone | 501-627-1800
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Fax | 501-627-1899
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Authorized Official
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Title or Position | CFO
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Name | MR. SHAWN BARNETT
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Credential |
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Telephone | 501-609-2229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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