Healthcare Provider Details

I. General information

NPI: 1982796819
Provider Name (Legal Business Name): COUNTY OF CALHOUN COUNTY JUDGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 05/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

449 9TH STREET
HAMPTON AR
71744
US

IV. Provider business mailing address

PO BOX 121
HAMPTON AR
71744-0121
US

V. Phone/Fax

Practice location:
  • Phone: 870-875-2273
  • Fax: 870-881-8989
Mailing address:
  • Phone: 870-875-2273
  • Fax: 870-881-8989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number547
License Number StateAR

VIII. Authorized Official

Name: FLOYD NUTT
Title or Position: COUNTY JUDGE
Credential:
Phone: 870-875-2273