Healthcare Provider Details

I. General information

NPI: 1750201430
Provider Name (Legal Business Name): BOARD OF GOVERNORS OF DALLAS COUNTY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N CLIFTON ST STE 3
FORDYCE AR
71742-3060
US

IV. Provider business mailing address

110 N CLIFTON ST STE 3
FORDYCE AR
71742-3060
US

V. Phone/Fax

Practice location:
  • Phone: 870-352-6226
  • Fax: 870-352-6490
Mailing address:
  • Phone: 870-352-6226
  • Fax: 870-352-6490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MECHELLE BROWN
Title or Position: PAYROLL
Credential:
Phone: 870-352-6465