Healthcare Provider Details

I. General information

NPI: 1407788599
Provider Name (Legal Business Name): DELTA HEALTH SERVICES COMMUNITY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 W WATERMAN ST
DUMAS AR
71639-2139
US

IV. Provider business mailing address

103 W WATERMAN ST
DUMAS AR
71639-2139
US

V. Phone/Fax

Practice location:
  • Phone: 870-377-9220
  • Fax:
Mailing address:
  • Phone: 870-377-9220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SKYE WELLS
Title or Position: CFO
Credential:
Phone: 870-382-4303