MEDICARE: HOT SPRINGS GASTROENTEROLOGY CLINIC

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	207RG0100X	Gastroenterology Physician	MC-0581	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174741375
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOT SPRINGS GASTROENTEROLOGY CLINIC

Provider Business Mailing Address
First Line	:	1 MERCY LN STE 307
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6440
Country	:	US
Telephone Number	:	501-623-4898
Fax Number	:	501-623-0260

Provider Business Practice Location Address
First Line	:	1 MERCY LN STE 307
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6440
Country	:	US
Telephone Number	:	501-623-4898
Fax Number	:	501-623-0260

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICHARD W. DUNN
Credential	:	M.D.
Telephone Number	:	501-623-4898

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	03/13/2012

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