Provider Demographics
NPI:1609845346
Name:OUACHITA REGIONAL DIAGNOSTIC AND SURGERY CENTER, INC.
Entity type:Organization
Organization Name:OUACHITA REGIONAL DIAGNOSTIC AND SURGERY CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-520-2000
Mailing Address - Street 1:1636 HIGDON FERRY RD
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6912
Mailing Address - Country:US
Mailing Address - Phone:501-520-2000
Mailing Address - Fax:501-520-3736
Practice Address - Street 1:1636 HIGDON FERRY RD
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6912
Practice Address - Country:US
Practice Address - Phone:501-520-2000
Practice Address - Fax:501-520-3736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR4180282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR10142OtherAR BLUE CROSS BLUE SHIELD
AR10142OtherAR BLUE CROSS BLUE SHIELD