Organization Name: | BOARD OF GOVERNORS OF DALLAS COUNTY MEDICAL CENTER |
NPI Number: | 1306826029 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOH R TUCKER (ADMINISTRATOR / CEO) |
Mailing Address: | 201 North Clifton Street Fordyce |
State: | AR US |
Postal Code: | 71742 |
Phone Number: | 8703526363 |
Fax Number: | 8703526343 |
NPI Enumeration Date: | 01/19/2006 |
NPI Last Update Date: | 04/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 282NC0060X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Hospitals |
Taxonomy Classification: | General Acute Care Hospital |
Taxonomy Specialization: | Critical Access |
Taxonomy Definition: |