Provider Demographics
NPI:1568465698
Name:BOOS, DONALD L JR (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:L
Last Name:BOOS
Suffix:JR
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 1:307 CARPENTER DAM RD STE F
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-8282
Mailing Address - Country:US
Mailing Address - Phone:501-262-1000
Mailing Address - Fax:501-262-1011
Practice Address - Street 1:307 CARPENTER DAM RD STE F
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-8282
Practice Address - Country:US
Practice Address - Phone:501-262-1000
Practice Address - Fax:501-262-1011
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARN8196208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR55507OtherBLUE CROSS/BLUE SHIELD
AR2020145OtherUNITED HEALTHCARE
AR121454001Medicaid
AR050060936OtherRAILROAD MEDICARE
AR55507OtherBLUE CROSS/BLUE SHIELD
ARE51678Medicare UPIN
AR2020145OtherUNITED HEALTHCARE