Provider Demographics
NPI:1376716290
Name:ACHARYA, YUBA RAJ (MD)
Entity Type:Individual
Prefix:DR
First Name:YUBA
Middle Name:RAJ
Last Name:ACHARYA
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:PO BOX 21850
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-1850
Mailing Address - Country:US
Mailing Address - Phone:501-625-8400
Mailing Address - Fax:501-625-8446
Practice Address - Street 1:200 HEARTCENTER LN
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6351
Practice Address - Country:US
Practice Address - Phone:501-625-8400
Practice Address - Fax:501-625-8446
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-11
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT186429207R00000X
ARE-9291207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR209503001Medicaid
AR429217YKDYMedicare PIN