Healthcare Provider Details
I. General information
NPI: 1952922981
Provider Name (Legal Business Name): MAGNOLIA REGIONAL HEALTH SYSTEM INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/30/2020
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 HOSPITAL DR
MAGNOLIA AR
71753-2415
US
IV. Provider business mailing address
PO BOX 629
MAGNOLIA AR
71754-0629
US
V. Phone/Fax
- Phone: 870-235-3000
- Fax:
- Phone: 870-235-3212
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
WILLIAM
D
GILES
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 870-235-3208