Healthcare Provider Details

I. General information

NPI: 1578777645
Provider Name (Legal Business Name): SOUTH ARKANSAS REGIONAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 LORENE ST
EL DORADO AR
71730-8129
US

IV. Provider business mailing address

1812 LORENE ST
EL DORADO AR
71730-8129
US

V. Phone/Fax

Practice location:
  • Phone: 870-863-8133
  • Fax: 870-863-4111
Mailing address:
  • Phone: 870-863-8133
  • Fax: 870-863-4111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM C. PEEL
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD
Phone: 870-863-8133