Healthcare Provider Details

I. General information

NPI: 1265114797
Provider Name (Legal Business Name): SEVIER COUNTY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2023
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 HIGHWAY 71 N
DE QUEEN AR
71832-9415
US

IV. Provider business mailing address

PO BOX 960
DE QUEEN AR
71832-0960
US

V. Phone/Fax

Practice location:
  • Phone: 870-642-6420
  • Fax: 870-584-1670
Mailing address:
  • Phone: 870-642-6420
  • Fax: 870-584-1670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: LORI L HOUSE
Title or Position: PRESIDENT/CEO
Credential:
Phone: 870-642-6420