NPIMap

Organization Active NPI

Midstate Medical Services PA

  • Anesthesiology Physician
  • Hot Springs, AR
National Provider Identifier
1851315501
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MC1263 Issued in AR
Legal business name
MIDSTATE MEDICAL SERVICES PA
Practice address
3810 Central Ave
Suite H
Hot Springs, AR 71913-6921
Phone
(501) 525-5840
Fax
(501) 525-1762
NPI assigned
Jul 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
William Glyn Wagnon, MDNPI 1699789008
Title
Owner
Phone
(501) 525-5840

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X MC1263 AR Primary

Addresses

Primary practice location

3810 Central Ave
Suite H
Hot Springs, AR 71913-6921

Mailing address

3810 Central Ave
Suite H
Hot Springs, AR 71913-6921
Phone (501) 525-5840

National Provider Directory

National Provider Directory

Locations

3810 Central Ave
Ste H
Hot Springs National Park, AR 71913
Phone (501) 525-5840

Practitioners & affiliated clinicians

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851315501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 CENTRAL AVE",
            "address_2": "SUITE H",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719136921",
            "telephone_number": "501-525-5840",
            "fax_number": "501-525-1762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 CENTRAL AVE",
            "address_2": "SUITE H",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719136921",
            "telephone_number": "501-525-5840",
            "fax_number": "501-525-1762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDSTATE MEDICAL SERVICES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAGNON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "GLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-525-5840",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "MC1263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.