Healthcare Provider Details

I. General information

NPI: 1689735326
Provider Name (Legal Business Name): MCSA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 W GROVE ST
EL DORADO AR
71730
US

IV. Provider business mailing address

PO BOX 1998
EL DORADO AR
71731-1998
US

V. Phone/Fax

Practice location:
  • Phone: 870-863-2000
  • Fax: 870-863-5442
Mailing address:
  • Phone: 870-863-2000
  • Fax: 870-863-5442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: REBECCA HURLEY
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 214-473-3993