Provider Demographics
NPI:1073575734
Name:DOCTORS HEALTH GROUP, INC
Entity Type:Organization
Organization Name:DOCTORS HEALTH GROUP, INC
Other - Org Name:RECTOR MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIEBLONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-932-7024
Mailing Address - Street 1:PO BOX 272
Mailing Address - Street 2:RECTOR MEDICAL CLINIC
Mailing Address - City:RECTOR
Mailing Address - State:AR
Mailing Address - Zip Code:72461-0272
Mailing Address - Country:US
Mailing Address - Phone:870-595-3527
Mailing Address - Fax:870-595-3530
Practice Address - Street 1:807 E 9TH ST
Practice Address - Street 2:
Practice Address - City:RECTOR
Practice Address - State:AR
Practice Address - Zip Code:72461-2406
Practice Address - Country:US
Practice Address - Phone:870-595-3527
Practice Address - Fax:870-595-3530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR130181729Medicaid
AR130181729Medicaid