MEDICARE: HOT SPRINGS MRI CENTER

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	2471M1202X	Magnetic Resonance Imaging Radiologic Technologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	57806	OTHER	AR	BCBS

General Provider Information

NPI Number	:	1801896410
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOT SPRINGS MRI CENTER

Provider Business Mailing Address
First Line	:	1 MERCY LN
Second Line	:	SUITE 104
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6442
Country	:	US
Telephone Number	:	501-623-9100
Fax Number	:	501-623-1639

Provider Business Practice Location Address
First Line	:	1 MERCY LN
Second Line	:	SUITE 104
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6442
Country	:	US
Telephone Number	:	501-623-9100
Fax Number	:	501-623-1639

Authorized Official
Title or Position	:	PARTNER/PRESIDENT
Name	:	DR. RICHARD PAUL TUCKER
Credential	:	M.D.
Telephone Number	:	501-623-9100

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	08/22/2020

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