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

General Provider Information

NPI Number	:	1922526888
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAXTER REGIONAL HEALTH SYSTEM

Provider Business Mailing Address
First Line	:	2161 HIGHWAY 56
Second Line	:
City	:	CALICO ROCK
State	:	AR
Zip	:	72519-7009
Country	:	US
Telephone Number	:	870-916-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2161 HIGHWAY 56
Second Line	:
City	:	CALICO ROCK
State	:	AR
Zip	:	72519-7009
Country	:	US
Telephone Number	:	870-916-2000
Fax Number	:

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

Provider Enumeration Date	:	08/31/2017
Last Update Date	:	05/13/2025

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Directions to “BAXTER REGIONAL HEALTH SYSTEM ” Practice Location

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