Healthcare Provider Details

I. General information

NPI: 1497174858
Provider Name (Legal Business Name): WHITE COUNTY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 W DEWITT HENRY DR
BEEBE AR
72012-2102
US

IV. Provider business mailing address

710 W DEWITT HENRY DR
BEEBE AR
72012-2102
US

V. Phone/Fax

Practice location:
  • Phone: 501-882-5433
  • Fax: 501-882-2512
Mailing address:
  • Phone: 501-882-5433
  • Fax: 501-882-2512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateAR

VIII. Authorized Official

Name: STUART R HILL
Title or Position: VP TREASURER
Credential:
Phone: 501-380-1004