Healthcare Provider Details

I. General information

NPI: 1699796342
Provider Name (Legal Business Name): QHG OF SPRINGDALE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3715 N BUS DR SUITE 104
FAYETTEVILL AR
72703
US

IV. Provider business mailing address

PO BOX 7360
SPRINGDALE AR
72766-7360
US

V. Phone/Fax

Practice location:
  • Phone: 479-757-4000
  • Fax: 479-757-2908
Mailing address:
  • Phone: 479-757-4000
  • Fax: 479-757-2908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberAR4112
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberAR4112
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberAR4112
License Number StateAR

VIII. Authorized Official

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