Provider Demographics
NPI:1316580996
Name:HMDOD LLC
Entity type:Organization
Organization Name:HMDOD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARVINDER
Authorized Official - Middle Name:S
Authorized Official - Last Name:DOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-875-1481
Mailing Address - Street 1:403 W OAK ST STE 101
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-4573
Mailing Address - Country:US
Mailing Address - Phone:870-875-1481
Mailing Address - Fax:
Practice Address - Street 1:403 W OAK ST STE 101
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-4573
Practice Address - Country:US
Practice Address - Phone:870-875-1481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARE-6833OtherSTATE LICENSE