1396818902 NPI number — HEALTHFIRST PHYSICIANS OF ARKANSAS

Table of content: DR. VICTOR ATIENZA DE LEON M.D. (NPI 1861564783)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396818902 NPI number — HEALTHFIRST PHYSICIANS OF ARKANSAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTHFIRST PHYSICIANS OF ARKANSAS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396818902
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/25/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1662 HIGDON FERRY RD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
HOT SPRINGS
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
71913-6912
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-623-2781
Provider Business Mailing Address Fax Number:
501-623-1774

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1662 HIGDON FERRY RD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
HOT SPRINGS
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
71913-6912
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-623-2781
Provider Business Practice Location Address Fax Number:
501-623-1774
Provider Enumeration Date:
11/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BODEMANN
Authorized Official First Name:
MARGARET
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
501-623-2781

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MC1988 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 131307002 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2026 www.npivalidator.com