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General NPI Number Information
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NPI Number | 1174741375
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Entity Type | Organization
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Legal Business Name | HOT SPRINGS GASTROENTEROLOGY CLINIC
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 03/13/2012
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Provider Practice Location Address
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Address Line | 1 MERCY LN STE 307
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City | HOT SPRINGS
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State | AR
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Zip | 71913-6440
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Country | US
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Telephone | 501-623-4898
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Fax | 501-623-0260
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Provider Business Mailing Address
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Address Line | 1 MERCY LN STE 307
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City | HOT SPRINGS
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State | AR
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Zip | 71913-6440
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Country | US
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Telephone | 501-623-4898
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Fax | 501-623-0260
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD W. DUNN
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Credential | M.D.
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Telephone | 501-623-4898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MC-0581
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License Number State | AR
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