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General NPI Number Information
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NPI Number | 1982510830
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Entity Type | Organization
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Legal Business Name | CHICOT MEMORIAL MEDICAL CENTER
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Dates
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Enumeration Date | 08/20/2026
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Last Update Date | 08/20/2026
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Provider Practice Location Address
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Address Line | 2729 S HIGHWAY 65 82
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City | LAKE VILLAGE
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State | AR
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Zip | 71653-6136
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Country | US
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Telephone | 870-265-9200
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Fax | 870-265-2091
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Provider Business Mailing Address
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Address Line | 2729 S HIGHWAY 65 82
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City | LAKE VILLAGE
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State | AR
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Zip | 71653-6136
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Country | US
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Telephone | 870-265-9200
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Fax | 870-265-2091
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Authorized Official
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Title or Position | CEO
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Name | VICKI J ALLEN
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Credential |
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Telephone | 870-265-9229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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