Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0000X | Obstetrician | 26911 | OK |
Y | 207VX0000X | Obstetrician | C-4534 | AR |
NPI | 1164491270 |
---|---|
Provider Name | Dr. James Douglas Studdard |
First Address | Hot Springs, AR 71901 |
Second Address | Little Rock, AR 72205-6225 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 15/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
104711001 | (05) | AR |
11273000000 | QUALCHOICE (01) | AR |
4211921 | AETNA (01) | AR |
55171 | BLUE CROSS BLUE SHIELD (01) | AR |
7420073 | UNITEDHEALTHCARE (01) | AR |
DO4940 | (02) | AR |