Provider Demographics
NPI:1821064593
Name:HOT SPRINGS PULMONARY CLINIC PA
Entity Type:Organization
Organization Name:HOT SPRINGS PULMONARY CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST OFF MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-623-5220
Mailing Address - Street 1:#1 MERCY LANE
Mailing Address - Street 2:STE 401
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913
Mailing Address - Country:US
Mailing Address - Phone:501-623-5220
Mailing Address - Fax:501-623-1546
Practice Address - Street 1:#1 MERCY LANE
Practice Address - Street 2:STE 401
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913
Practice Address - Country:US
Practice Address - Phone:501-623-5220
Practice Address - Fax:501-623-1546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMO1066207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5B840Medicare ID - Type Unspecified