Provider Demographics
NPI:1851364608
Name:HOT SPRINGS SURGERY CLINIC
Entity Type:Organization
Organization Name:HOT SPRINGS SURGERY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:WILLOUGHBY
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-624-5700
Mailing Address - Street 1:1900 MALVERN AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-7759
Mailing Address - Country:US
Mailing Address - Phone:501-624-5700
Mailing Address - Fax:501-624-6519
Practice Address - Street 1:1900 MALVERN AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-7759
Practice Address - Country:US
Practice Address - Phone:501-624-5700
Practice Address - Fax:501-624-6519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC4921261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR50888Medicare ID - Type Unspecified
AR57223Medicare ID - Type Unspecified
ARC67954Medicare UPIN