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General NPI Number Information
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NPI Number | 1912365982
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Entity Type | Organization
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Legal Business Name | BAXTER REGIONAL HEALTH SYSTEM
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Dates
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Enumeration Date | 02/05/2016
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 103 MOUNTAIN PLACE DR STE C
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City | MOUNTAIN VIEW
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State | AR
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Zip | 72560-6802
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Country | US
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Telephone | 870-269-3447
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1695
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City | MOUNTAIN VIEW
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State | AR
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Zip | 72560-1695
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Country | US
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Telephone | 870-269-3447
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | DEBRA HENRY
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Credential |
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Telephone | 870-508-1003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | AR
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