Provider Demographics
NPI:1760470983
Name:HARDY, ROSS ALAN (M D)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:ALAN
Last Name:HARDY
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 HIGDON FERRY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6913
Mailing Address - Country:US
Mailing Address - Phone:501-525-4785
Mailing Address - Fax:501-525-4794
Practice Address - Street 1:1635 HIGDON FERRY RD
Practice Address - Street 2:SUITE A
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6913
Practice Address - Country:US
Practice Address - Phone:501-525-4785
Practice Address - Fax:501-525-4794
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC8261208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA129352OtherDEPT. OF LABOR
AR250008927OtherMEDICARE RAILROAD
P00319107OtherRAILROAD MEDICARE
AR5J031Medicare ID - Type Unspecified
AR171953000OtherDEPT. OF LABOR
ARF49769Medicare UPIN
AR169740000OtherQUALCHOICE INSURANCE
AR130147001Medicaid