Healthcare Provider Details

I. General information

NPI: 1215102702
Provider Name (Legal Business Name): HOWARD MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 12/18/2019
Certification Date: 12/18/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 MEDICAL CIRCLE
NASHVILLE AR
71852
US

IV. Provider business mailing address

130 MEDICAL CIRCLE
NASHVILLE AR
71852
US

V. Phone/Fax

Practice location:
  • Phone: 870-845-8024
  • Fax: 870-845-8027
Mailing address:
  • Phone: 870-845-8024
  • Fax: 870-845-8027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. KAITLYN GUNN
Title or Position: CLINIC FINANCIAL DIRECTOR
Credential:
Phone: 870-845-6051