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Individual

DR. STEPHEN G DIVERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
133 HARMONY PARK, HOT SPRINGS, AR 71913-5417
(501) 624-7700
(501) 623-5788
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(239) 432-8331
(813) 321-1296

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
E4010
AR
207RX0202X
Medical Oncology Physician
E4010
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
154309001
AR
01
P00115171
RAILROAD MEDICARE
Enumeration date
12/23/2005
Last updated
12/29/2022
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