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
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
Other
Enumeration date
09/25/2014
Last updated
09/25/2014
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