Provider Demographics
NPI:1215560891
Name:HUDSPETH, BETHANY JOY
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:JOY
Last Name:HUDSPETH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 EAST MARKET AVE BOX 12738
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72149-0001
Mailing Address - Country:US
Mailing Address - Phone:318-481-9043
Mailing Address - Fax:
Practice Address - Street 1:915 E MARKET AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72149-5615
Practice Address - Country:US
Practice Address - Phone:318-481-9043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer