MEDICARE: RODRIGO T CAMACHO APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	A02909	AR

General Provider Information

NPI Number	:	1053466276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODRIGO T CAMACHO APRN

Provider Business Mailing Address
First Line	:	124 SAWTOOTH OAK ST
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71901-7160
Country	:	US
Telephone Number	:	501-623-7800
Fax Number	:	833-398-2051

Provider Business Practice Location Address
First Line	:	124 SAWTOOTH OAK ST
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71901-7160
Country	:	US
Telephone Number	:	501-623-7800
Fax Number	:	833-398-2051

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	11/13/2025

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