Basic Information
| Provider Information | |||||||||
| NPI: | 1699189407 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VILLEDA | ||||||||
| FirstName: | VIRGILIO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 21850 | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719031850 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016092222 | ||||||||
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| Practice Location | |||||||||
| Address1: | ONE MERCY LANE SUITE 404 | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719137637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016092222 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2014 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 2014017892 | MO | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | E-10059 | AR | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.