Individual provider Active NPI

Dowling Bluford Stough IV, MD

  • Dermatology Physician
  • Hot Springs, AR
National Provider Identifier
1831199884
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
C6673 Issued in AR
Practice address
3633 Central Ave
Ste N
Hot Springs, AR 71913-6404
Phone
(501) 623-6100
Fax
(501) 623-6187
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X C6673 AR Primary

Addresses

Primary practice location

3633 Central Ave
Ste N
Hot Springs, AR 71913-6404

Mailing address

3633 Central Ave
Ste N
Hot Springs, AR 71913-6404
Phone (501) 623-6100

Other identifiers 1

IdentifierTypeStateIssuer
115184001MedicaidAR

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL thedermatologyclinicofarkansas.ema.md Health Information Exchange (HIE) The Dermatology Clinic PA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100818000099 AR Practitioner - Dermatology 7911986583 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C6673ARMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Aug 1, 2018 Accepting new patients
University of Arkansas for Medical Sciences Dermatology CurrentSince Aug 1, 2018 Accepting new patients
The Dermatology Clinic PA Dermatology CurrentSince Mar 1, 1992 Accepting new patients
The Dermatology Clinic PA Dermatology CurrentSince Feb 23, 2020 Accepting new patients

Locations

3633 Central Ave
Ste N
Hot Springs National Park, AR 71913
Phone (501) 623-6100

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1831199884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 CENTRAL AVE",
            "address_2": "STE N",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719136404",
            "telephone_number": "501-623-6100",
            "fax_number": "501-623-6187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 CENTRAL AVE",
            "address_2": "STE N",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719136404",
            "telephone_number": "501-623-6100",
            "fax_number": "501-623-6187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUGH",
        "first_name": "DOWLING",
        "middle_name": "BLUFORD",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AR",
            "license": "C6673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115184001",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "thedermatologyclinicofarkansas.ema.md",
            "affiliation": "Y",
            "endpointDescription": "Software system URL for EHR EMR",
            "affiliationName": "The Dermatology Clinic PA",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3633 Central Ave Ste N",
            "city": "Hot Springs",
            "state": "AR",
            "country_code": "US",
            "postal_code": "719136475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hot Springs, AR

Sources for this page

Verify at the official NPI Registry.