Healthcare Provider Details

I. General information

NPI: 1376662759
Provider Name (Legal Business Name): PIGGOTT COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 10/26/2023
Certification Date: 10/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1206 GORDON DUCKWORTH DR
PIGGOTT AR
72454-1911
US

IV. Provider business mailing address

1206 GORDON DUCKWORTH DR
PIGGOTT AR
72454-1911
US

V. Phone/Fax

Practice location:
  • Phone: 870-598-3881
  • Fax: 870-598-3536
Mailing address:
  • Phone: 870-598-3881
  • Fax: 870-598-3536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberAR3945(B)
License Number StateAR

VIII. Authorized Official

Name: MR. JAMES L MAGEE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 870-598-3881