Healthcare Provider Details

I. General information

NPI: 1396664736
Provider Name (Legal Business Name): ST VINCENT INFIRMARY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 HOSPITAL DR
MORRILTON AR
72110-4510
US

IV. Provider business mailing address

4 HOSPITAL DR
MORRILTON AR
72110-4510
US

V. Phone/Fax

Practice location:
  • Phone: 501-977-2413
  • Fax: 501-977-2260
Mailing address:
  • Phone: 501-977-2413
  • Fax: 501-977-2260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHAD ADUDDELL
Title or Position: MARKET CEO
Credential:
Phone: 501-552-3906