Organization
OUACHITA REGIONAL ANESTHESIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD IVY MD (DELEGATED AUTHORIZED OFFICIAL)
(800) 235-1415
Entity
Organization
Contact information
Practice address
1910 MALVERN AVE, HOT SPRINGS, AR 71901-7752
(501) 321-1000
Mailing address
PO BOX 22390, HOT SPRINGS, AR 71903-2390
(800) 235-1415
(913) 234-1108
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149392002
—
AR
01
—
5C752
AR BCBS PROVIDER NUMBER
AR
01
—
CK6327
RR MEDICARE
—
Enumeration date
09/14/2005
Last updated
07/21/2022
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