Provider Demographics
NPI:1164491270
Name:STUDDARD, JAMES DOUGLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DOUGLAS
Last Name:STUDDARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 MALVERN AVENUE
Mailing Address - Street 2:STE 401
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901
Mailing Address - Country:US
Mailing Address - Phone:501-623-6455
Mailing Address - Fax:501-623-7257
Practice Address - Street 1:9501 BAPTIST HEALTH DR
Practice Address - Street 2:STE. 800
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6225
Practice Address - Country:US
Practice Address - Phone:501-223-2080
Practice Address - Fax:501-223-2088
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK26911207VX0000X
ARC-4534207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR7420073OtherUNITEDHEALTHCARE
AR104711001Medicaid
AR4211921OtherAETNA
AR11273000000OtherQUALCHOICE
AR55171OtherBLUE CROSS BLUE SHIELD
ARDO4940Medicare UPIN
AR55171OtherBLUE CROSS BLUE SHIELD