Provider Demographics
NPI:1144284852
Name:HOT SPRINGS BONE & JOINT CLINIC PA
Entity type:Organization
Organization Name:HOT SPRINGS BONE & JOINT CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:501-321-1026
Mailing Address - Street 1:1 MERCY LN
Mailing Address - Street 2:SUITE 404
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6442
Mailing Address - Country:US
Mailing Address - Phone:501-321-1026
Mailing Address - Fax:501-623-1021
Practice Address - Street 1:1 MERCY LN
Practice Address - Street 2:SUITE 404
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6442
Practice Address - Country:US
Practice Address - Phone:501-321-1026
Practice Address - Fax:501-623-1021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR54927B401OtherPHYSICIAN PIN
AR113160002Medicaid
AR113160002Medicaid
AR5B401Medicare PIN