Provider Demographics
NPI:1831532837
Name:HURST, ADAM ROWE (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:ROWE
Last Name:HURST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 S CHURCH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-4112
Mailing Address - Country:US
Mailing Address - Phone:870-935-6012
Mailing Address - Fax:
Practice Address - Street 1:800 S CHURCH ST STE 400
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4112
Practice Address - Country:US
Practice Address - Phone:870-935-6012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ARE10382208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL184942Medicaid
AR219679001Medicaid