Individual
KERRY ELIZABETH MAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 MERCY LN, SUITE 201, HOT SPRINGS, AR 71913-6442
(501) 609-2222
(501) 321-9689
Mailing address
PO BOX 21850, HOT SPRINGS, AR 71903-1850
(501) 609-2222
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M0476
TX
208M00000X
Hospitalist Physician
Primary
E-2055
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137704001
—
AR
05
—
170823201
—
TX
05
—
170823203
—
TX
05
—
170823204
—
TX
05
—
170823205
—
TX
05
—
170823206
—
TX
Enumeration date
04/11/2006
Last updated
11/09/2020
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