Healthcare Provider Details

I. General information

NPI: 1861018111
Provider Name (Legal Business Name): BAPTIST HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2020
Last Update Date: 06/23/2020
Certification Date: 06/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2913 CYPRESS RD STE 100
ARKADELPHIA AR
71923-4251
US

IV. Provider business mailing address

2913 CYPRESS RD STE 100
ARKADELPHIA AR
71923-4251
US

V. Phone/Fax

Practice location:
  • Phone: 870-246-2471
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TROY WELLS
Title or Position: PRESIDENT
Credential:
Phone: 501-202-2080