David J Waddell
Geriatric Medicine
624 Hospital Dr
Mountain Home
, Arkansas 72653-2955
David J Waddell
Geriatric Medicine
624 Hospital Dr
Mountain Home
, Arkansas 72653-2955
(870) 424-3089
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About
Features
Specialties
- Geriatric Medicine
Languages spoken
- English
Location
First Address
- David J Waddell
- 860 Highway 62 E Ste 10
- Mountain Home, AR
- Zip : 72653-3200
- Fax : (870) 424-3089
- Phone : (870) 424-3181
Second Address
- David J Waddell
- 624 Hospital Dr
- Mountain Home, AR
- Zip : 72653-2955
- Fax : (870) 424-3089
- Phone : (870) 508-1000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207RG0300X | Geriatric Medicine | 31608 | IA |
National Provider Identifier
| NPI | 1144239500 |
|---|---|
| Provider Name | David J Waddell |
| First Address | Mountain Home, AR 72653-3200 |
| Second Address | Mountain Home, AR 72653-2955 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/08/2006 |
| Last Update Date | 07/03/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0148593 | (05) | IA |
| 110149386 | RR MEDICARE (01) | IA |
| 208691204 | (05) | MO |
| 209747001 | (05) | AR |
| 419099YWUJ | MEDICARE (01) | AR |
| 421202636 | TAX ID (01) | IA |
| G44973 | (02) | IA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.