DR. ROGER LEW HIATT JR. (NPI# 1417082710) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417082710 |
| Entity Type | Individual |
| Full Name | DR. ROGER LEW HIATT JR. |
| Credential | MD |
| Practice Address |
600 N 7th St West Memphis AR 72301-3235 |
| Mailing Address |
10047 Bushrod Cv Collierville TN 38017-9188 |
| Practice Telephone | 8703947100 |
| Practice Fax Number | 8703947111 |
| Mailing Telephone | 8012005050 |
| Mailing Fax Number | 8703947111 |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2019-12-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
N-8381 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 130272001 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6501 W 12th St, Little Rock, AR 722041511 | 5016668686 |
| Street Address |
600 N 7TH ST |
| City | WEST MEMPHIS |
| State | AR |
| Zip Code | 72301-3235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134521685 | Woodridge of West Memphis, LLC | Psychiatric Hospital | 600 N 7th St, West Memphis, AR 72301-3235 | 2014-09-16 |
| 1134305436 | Woodridge Northeast, LLC | Psychiatric Residential Treatment Facility | 600 N 7th St, West Memphis, AR 72301 | 2008-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235755497 | Shannon Mcelroy | Pharmacist | 300 I-40 Service Rd, West Memphis, AR 72301 | 2020-06-23 |
| 1891319745 | Heather Nichole Fesperman | Nurse Practitioner | 420 W Cooper Ave, West Memphis, AR 72301 | 2020-06-05 |
| 1174161475 | Mary Williams | Pharmacist | 300 I-40 Service Road, West Memphis, AR 72301 | 2019-12-17 |
| 1336787035 | Yolanda Monique Fulton | Assisted Living Facility | 711 Purduve Ave, West Memphis, AR 72301 | 2019-12-13 |
| 1255813317 | Urgent Care Travel, Inc | Clinic/Center | 3400 Service Loop 2, West Memphis, AR 72301 | 2018-09-05 |
| 1841770302 | Cuffie Healthcare LLC | Home Health | 403 Ingram Blvd, West Memphis, AR 72301 | 2018-08-15 |
| 1467940312 | Mark Aaron Whitlock | Dentist | 110 Dover Rd, West Memphis, AR 72301 | 2018-04-26 |
| 1043715329 | Crossroads Treatment Center of West Memphis, PC | Clinic/Center | 103 S Avalon St, West Memphis, AR 72301 | 2018-03-28 |
| 1114445202 | Deborah Thompson Ferguson | Dentist | 200 S Rhodes St Ste B, West Memphis, AR 72301 | 2017-09-08 |
| 1154745487 | Erin Camille Greer | Specialist/Technologist | 610 N. Missouri Street, Suite 1, West Memphis, AR 72301 | 2014-02-06 |
| Find all providers in zip 72301 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285189290 | John C. Leach, Md Pllc | Psychiatry & Neurology | 75 Wellington Colony Dr, Little Rock, AR 72211-2089 | 2016-08-19 |
| 1326350885 | Nihit Kumar | Psychiatry & Neurology | 4301 W Markham St # 589, Little Rock, AR 72205-7101 | 2010-07-12 |
| 1457679011 | Kelsey L.m. Mcclellan | Psychiatry & Neurology | 124 W Capitol Ave, Suite 1900, Little Rock, AR 72201-3704 | 2010-05-06 |
| 1043331010 | Samuel Tyler Armstrong Bayles | Psychiatry & Neurology | 700 S Schiller St, Little Rock, AR 72201-4735 | 2007-04-03 |
| 1548381510 | Kathryn A Panek | Psychiatry & Neurology | 74 W Sunbridge Dr, Suite 1, Fayetteville, AR 72703-1822 | 2007-04-03 |
| 1467528026 | University of Arkansas for Medical Sciences | Psychiatry & Neurology | 11 Childrens Way # 854, Little Rock, AR 72202 | 2006-11-27 |
| 1801999289 | Thomas W Freeman | Psychiatry & Neurology | 3604 Central Avenue, Suite C, Hot Springs, AR 71913 | 2006-09-07 |
| 1689617417 | Norman I Snyder | Psychiatry & Neurology | 4253 N Crossover Rd, Suite 2, Fayetteville, AR 72703-4593 | 2006-06-13 |
| 1154370518 | Zarina Shah | Psychiatry & Neurology | 5905 Forest Pl, Centers for Youth and Families, Suite 210, Little Rock, AR 72207-5245 | 2006-05-10 |
| 1376518589 | Atif M Akhtar | Psychiatry & Neurology | 350 Salem Rd Ste 1, Conway, AR 72034 | 2006-02-21 |
| Find all providers with the same taxonomy | ||||
| City | WEST MEMPHIS |
| Zip Code | 72301 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.