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NPI Code Detail

MEDICARE: BAXTER REGIONAL HEALTH SYSTEM

MEDICARE: BAXTER REGIONAL HEALTH SYSTEM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology Physician

General Provider Information

NPI Number : 1639882863
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAXTER REGIONAL HEALTH SYSTEM
Provider Business Mailing Address
First Line : PO BOX 1267
Second Line :
City : MOUNTAIN HOME
State : AR
Zip : 72654-1267
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 715 W SHERMAN AVE STE A
Second Line :
City : HARRISON
State : AR
Zip : 72601-2737
Country : US
Telephone Number : 870-741-2317
Fax Number : 870-741-4090
Authorized Official
Title or Position : CFO
Name : DEBRA HENRY
Credential :
Telephone Number : 870-508-1003
Provider Enumeration Date : 01/03/2023
Last Update Date : 01/03/2023

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Directions to “BAXTER REGIONAL HEALTH SYSTEM ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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