Healthcare Provider Details
I. General information
NPI: 1255513453
Provider Name (Legal Business Name): PHILLIPS HOSPITAL COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/29/2007
Last Update Date: 09/02/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1801 MARTIN LUTHER KING JR DR
HELENA AR
72342-8998
US
IV. Provider business mailing address
1801 MARTIN LUTHER KING JR DR
HELENA AR
72342-8998
US
V. Phone/Fax
- Phone: 870-338-5800
- Fax:
- Phone: 870-816-3900
- Fax: 870-816-3909
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
TAYLOR
MARSHALL
Title or Position: DIRECTOR OF PROVIDER ENROLLMENT
Credential:
Phone: 615-465-7626