Provider Demographics
NPI:1568082840
Name:HOT SPRINGS HEART AND VASCULAR CORP
Entity Type:Organization
Organization Name:HOT SPRINGS HEART AND VASCULAR CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:TAUTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-622-7691
Mailing Address - Street 1:312 LONG ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-9636
Mailing Address - Country:US
Mailing Address - Phone:501-622-7691
Mailing Address - Fax:
Practice Address - Street 1:110 CRACKER BOX LN
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS NATIONAL PARK
Practice Address - State:AR
Practice Address - Zip Code:71913-5418
Practice Address - Country:US
Practice Address - Phone:501-767-4278
Practice Address - Fax:501-767-4328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-16
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1C0710OtherMEDICARE PTAN