Provider Demographics
NPI:1487107967
Name:DORSETT, HAYDEN (PT)
Entity type:Individual
Prefix:
First Name:HAYDEN
Middle Name:
Last Name:DORSETT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10014 N. RODNEY PARHAM RD. STE. 103
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116
Mailing Address - Country:US
Mailing Address - Phone:501-224-5454
Mailing Address - Fax:501-224-5460
Practice Address - Street 1:2504 MCCAIN BLVD. SUITE 230
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-4801
Practice Address - Country:US
Practice Address - Phone:501-758-5555
Practice Address - Fax:507-758-5941
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-01
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4160225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR4160OtherPT LICENSE