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General NPI Number Information
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NPI Number | 1700914694
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Entity Type | Organization
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Legal Business Name | JEFFREY W. HERROLD, M. D., P.A.
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 01/05/2012
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Provider Practice Location Address
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Address Line | 135 MEDICAL PARK PL
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City | HOT SPRINGS
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State | AR
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Zip | 71901-8099
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Country | US
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Telephone | 501-623-2500
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Fax | 501-623-5155
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Provider Business Mailing Address
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Address Line | 135 MEDICAL PARK PL
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City | HOT SPRINGS
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State | AR
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Zip | 71901-8099
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Country | US
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Telephone | 501-623-2500
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Fax | 501-623-5155
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY W. HERROLD
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Credential | M. D.
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Telephone | 501-623-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | C6620
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License Number State | AR
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