MEDICARE: DR. JAMES DOUGLAS STUDDARD MD

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	207VX0000X	Obstetrics Physician	26911	OK
2	207VX0000X	Obstetrics Physician	C-4534	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7420073	OTHER	AR	UNITEDHEALTHCARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4211921	OTHER	AR	AETNA
4	11273000000	OTHER	AR	QUALCHOICE
5	55171	OTHER	AR	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1164491270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES DOUGLAS STUDDARD MD

Provider Business Mailing Address
First Line	:	1900 MALVERN AVENUE
Second Line	:	STE 401
City	:	HOT SPRINGS
State	:	AR
Zip	:	71901
Country	:	US
Telephone Number	:	501-623-6455
Fax Number	:	501-623-7257

Provider Business Practice Location Address
First Line	:	9501 BAPTIST HEALTH DR
Second Line	:	STE. 800
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-6225
Country	:	US
Telephone Number	:	501-223-2080
Fax Number	:	501-223-2088

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	10/15/2020

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Directions to “ DR. JAMES DOUGLAS STUDDARD MD” Practice Location

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