Organization Name: | BOARD OF GOVERNORS OF DALLAS COUNTY MEDICAL CENTER |
NPI Number: | 1346378528 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN 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: | 03/01/2007 |
NPI Last Update Date: | 04/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | AR4115 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |