Basic Information
| Provider Information | |||||||||
| NPI: | 1356982813 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTH ARKANSAS MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 620 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HARRISON | ||||||||
| State: | AR | ||||||||
| PostalCode: | 726012911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8704144420 | ||||||||
| FaxNumber: | 8704144789 | ||||||||
| Practice Location | |||||||||
| Address1: | 4052 E VAN BUREN STE A | ||||||||
| Address2: | |||||||||
| City: | EUREKA SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 726329328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4792535474 | ||||||||
| FaxNumber: | 4792535476 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2019 | ||||||||
| LastUpdateDate: | 10/04/2019 | ||||||||
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| AuthorizedOfficialLastName: | PANNELL | ||||||||
| AuthorizedOfficialFirstName: | KENNETH | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP FINANCE/CFO | ||||||||
| AuthorizedOfficialTelephone: | 8704145157 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.