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Organization
HENDERSON STATE UNIVERSITY
Active
Organization
HENDERSON STATE UNIVERSITY
Active
Other names
Henderson State Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
ROB REDDING (ASST. ATHLETICS DIRECTOR)
(870) 230-5069
Entity
Organization
Contact information
Practice address
1100 HENDERSON ST, HSU BOX 7630, ARKADELPHIA, AR 71999-0001
(870) 230-5426
Mailing address
5050 SPRING VALLEY RD, DALLAS, TX 75244-3995
(800) 555-9073
(972) 367-3452
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
NULL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
Other
Enumeration date
09/25/2014
Last updated
09/25/2014
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