Healthcare Provider Details

I. General information

NPI: 1255190989
Provider Name (Legal Business Name): BAPTIST HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2024
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 OPPORTUNITY DR
SHERIDAN AR
72150-9185
US

IV. Provider business mailing address

9601 BAPTIST HEALTH DR
LITTLE ROCK AR
72205-6321
US

V. Phone/Fax

Practice location:
  • Phone: 501-337-9066
  • Fax:
Mailing address:
  • Phone: 501-202-2080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TROY WELLS
Title or Position: PRESIDENT
Credential:
Phone: 501-202-2080