MEDICARE: ROBERT FORE M D

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	174400000X	Specialist	C4712	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C4712	OTHER	AR	STATE LICENSE

General Provider Information

NPI Number	:	1952391104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT FORE M D

Provider Business Mailing Address
First Line	:	3633 CENTRAL AVE
Second Line	:	STE D
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6404
Country	:	US
Telephone Number	:	501-623-6693
Fax Number	:	501-623-9403

Provider Business Practice Location Address
First Line	:	3633 CENTRAL AVE
Second Line	:	STE D
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6404
Country	:	US
Telephone Number	:	501-623-6693
Fax Number	:	501-623-9403

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

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	03/07/2023

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Directions to “ ROBERT FORE M D” Practice Location

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