Provider Demographics
NPI:1609861806
Name:STEADMAN, EDWARD (P T)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:STEADMAN
Suffix:
Gender:M
Credentials:P T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 GARRISON RD
Mailing Address - Street 2:STE B
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6482
Mailing Address - Country:US
Mailing Address - Phone:501-520-0504
Mailing Address - Fax:501-520-0245
Practice Address - Street 1:216 GARRISON RD
Practice Address - Street 2:STE B
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-7191
Practice Address - Country:US
Practice Address - Phone:501-520-0504
Practice Address - Fax:501-520-0245
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
ARPT2362225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1528397833OtherGROUP NPI