Basic Information
| Provider Information | |||||||||
| NPI: | 1780941625 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTH ARKANSAS REGIONAL MEDICAL CENTER | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | NARMC MEDICINE GROUP | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 724 N SPRING ST STE D | ||||||||
| Address2: | |||||||||
| City: | HARRISON | ||||||||
| State: | AR | ||||||||
| PostalCode: | 726012913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8704144000 | ||||||||
| FaxNumber: | 8704144789 | ||||||||
| Practice Location | |||||||||
| Address1: | 724 N SPRING ST STE A | ||||||||
| Address2: | |||||||||
| City: | HARRISON | ||||||||
| State: | AR | ||||||||
| PostalCode: | 726012913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8703650850 | ||||||||
| FaxNumber: | 8703650862 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2012 | ||||||||
| LastUpdateDate: | 09/19/2022 | ||||||||
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| AuthorizedOfficialLastName: | PANNELL | ||||||||
| AuthorizedOfficialFirstName: | KEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP FINANCE/CFO | ||||||||
| AuthorizedOfficialTelephone: | 8704145157 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 09/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice | 207Q00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 193249002 | 05 | AR | MEDICAID |