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General NPI Number Information
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NPI Number | 1245097559
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Entity Type | Organization
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Legal Business Name | HASELOW ENTERPRISES LLC
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Dates
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Enumeration Date | 03/04/2024
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 9408 MILLERS POINTE CT
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City | SHERWOOD
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State | AR
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Zip | 72120-2491
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Country | US
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Telephone | 501-442-8129
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Fax |
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Provider Business Mailing Address
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Address Line | 9408 MILLERS POINTE CT
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City | SHERWOOD
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State | AR
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Zip | 72120-2491
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Country | US
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Telephone | 501-442-8129
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DIRK THOMAS HASELOW
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Credential | MD
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Telephone | 501-442-8129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number |
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License Number State |
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