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
1	207Q00000X	Family Medicine Physician		AR

General Provider Information

NPI Number	:	1912365982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAXTER REGIONAL HEALTH SYSTEM

Provider Business Mailing Address
First Line	:	PO BOX 1695
Second Line	:
City	:	MOUNTAIN VIEW
State	:	AR
Zip	:	72560-1695
Country	:	US
Telephone Number	:	870-269-3447
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 MOUNTAIN PLACE DR STE C
Second Line	:
City	:	MOUNTAIN VIEW
State	:	AR
Zip	:	72560-6802
Country	:	US
Telephone Number	:	870-269-3447
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	DEBRA HENRY
Credential	:
Telephone Number	:	870-508-1003

Provider Enumeration Date	:	02/05/2016
Last Update Date	:	05/13/2025

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Directions to “BAXTER REGIONAL HEALTH SYSTEM ” Practice Location

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