Provider Demographics
NPI:1437359742
Name:WHITE COUNTY MEDICAL CENTER
Entity Type:Organization
Organization Name:WHITE COUNTY MEDICAL CENTER
Other - Org Name:WHITE COUNTY EMERGENCY PHYSICIANS GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-380-1004
Mailing Address - Street 1:3214 E RACE AVE
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4810
Mailing Address - Country:US
Mailing Address - Phone:501-380-2103
Mailing Address - Fax:501-380-2101
Practice Address - Street 1:3214 E RACE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4810
Practice Address - Country:US
Practice Address - Phone:501-380-2103
Practice Address - Fax:501-380-2101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARCS5914OtherRAILROAD MEDICARE
AR130770002Medicaid
AR130770002Medicaid