Provider Demographics
NPI:1467176966
Name:NORTH ARKANSAS REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:NORTH ARKANSAS REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:VIKKIE
Authorized Official - Middle Name:HENDRICKS
Authorized Official - Last Name:RUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-414-4420
Mailing Address - Street 1:PO BOX 2990
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72602-2990
Mailing Address - Country:US
Mailing Address - Phone:870-414-4420
Mailing Address - Fax:
Practice Address - Street 1:715 W SHERMAN AVE STE A
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-2737
Practice Address - Country:US
Practice Address - Phone:870-741-2317
Practice Address - Fax:870-741-4090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty