Provider Demographics
NPI:1194755165
Name:PRICE, HERBERT H III (MD)
Entity type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:H
Last Name:PRICE
Suffix:III
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 1:920 UNION ST
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-3526
Mailing Address - Country:US
Mailing Address - Phone:870-935-8676
Mailing Address - Fax:870-972-8603
Practice Address - Street 1:920 UNION ST
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-3526
Practice Address - Country:US
Practice Address - Phone:870-935-8676
Practice Address - Fax:870-972-8603
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC5665101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARC5665OtherSTATE MEDICAL LICENSE
ARC5665OtherSTATE MEDICAL LICENSE
AR51538Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER