Provider Demographics
NPI:1851114003
Name:VASCULAR CENTER OF HOT SPRINGS
Entity type:Organization
Organization Name:VASCULAR CENTER OF HOT SPRINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUANITA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:PATINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-626-8724
Mailing Address - Street 1:110 CRACKER BOX LN
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-5418
Mailing Address - Country:US
Mailing Address - Phone:833-626-8724
Mailing Address - Fax:210-783-1910
Practice Address - Street 1:110 CRACKER BOX LN
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-5418
Practice Address - Country:US
Practice Address - Phone:833-626-8724
Practice Address - Fax:210-783-1910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery