Provider Demographics
NPI:1568815835
Name:HOT SPRINGS PHYSICAL MEDICINE & REHABILITATION CLINIC PLLC
Entity Type:Organization
Organization Name:HOT SPRINGS PHYSICAL MEDICINE & REHABILITATION CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:A
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-525-4785
Mailing Address - Street 1:1635 HIGDON FERRY RD STE A
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6904
Mailing Address - Country:US
Mailing Address - Phone:501-525-4785
Mailing Address - Fax:501-525-4794
Practice Address - Street 1:1635 HIGDON FERRY RD STE A
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6904
Practice Address - Country:US
Practice Address - Phone:501-525-4785
Practice Address - Fax:501-525-4794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-21
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-8261208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty