Provider Demographics
NPI:1952391104
Name:FORE, ROBERT (M D)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:FORE
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 1:3633 CENTRAL AVE
Mailing Address - Street 2:STE D
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6404
Mailing Address - Country:US
Mailing Address - Phone:501-623-6693
Mailing Address - Fax:501-623-9403
Practice Address - Street 1:3633 CENTRAL AVE
Practice Address - Street 2:STE D
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6404
Practice Address - Country:US
Practice Address - Phone:501-623-6693
Practice Address - Fax:501-623-9403
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC4712174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARC4712OtherSTATE LICENSE
AF1518969OtherDEA LICENSE
D04504Medicare UPIN
AR51744Medicare PIN