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General NPI Number Information
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NPI Number | 1306996145
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Entity Type | Organization
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Legal Business Name | JACK A. CATES, M.D.P.A.
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 11/19/2012
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Provider Practice Location Address
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Address Line | 1710 MALVERN AVE
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City | HOT SPRINGS
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State | AR
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Zip | 71901-7132
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Country | US
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Telephone | 501-624-3376
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Fax | 501-624-5609
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Provider Business Mailing Address
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Address Line | 1710 MALVERN AVE
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City | HOT SPRINGS
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State | AR
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Zip | 71901-7132
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Country | US
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Telephone | 501-624-3376
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Fax | 501-624-5609
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ANNETTE BOSSON
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Credential |
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Telephone | 501-624-3376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | R-2487
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License Number State | AR
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