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General NPI Number Information
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NPI Number | 1801303144
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Entity Type | Organization
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Legal Business Name | HEALTHY CONNECTIONS SPECIALTY, LLC
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Dates
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Enumeration Date | 01/09/2018
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Last Update Date | 08/13/2021
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Provider Practice Location Address
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Address Line | 208 MCAULEY CT STE B
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City | HOT SPRINGS
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State | AR
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Zip | 71913-6312
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Country | US
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Telephone | 888-710-8220
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1848
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City | MENA
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State | AR
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Zip | 71953-1841
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Country | US
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Telephone | 479-437-3449
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | SHANA BUSH
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Credential |
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Telephone | 479-437-3449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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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 | 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 #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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