Healthcare Provider Details

I. General information

NPI: 1699023895
Provider Name (Legal Business Name): WASHINGTON REGIONAL MEDICAL SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2012
Last Update Date: 08/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 HIGHWAY 62 65 N
HARRISON AR
72601-1959
US

IV. Provider business mailing address

1420 HIGHWAY 62 65 N
HARRISON AR
72601-1959
US

V. Phone/Fax

Practice location:
  • Phone: 870-741-3600
  • Fax: 870-741-6800
Mailing address:
  • Phone: 870-741-3600
  • Fax: 870-741-6800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL D CASH
Title or Position: DIRECTOR OF CLINIC OPERATIONS
Credential:
Phone: 479-463-1390