Organization Name: | BAPTIST HEALTH |
NPI Number: | 1659781151 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TROY WELLS (PRESIDENT) |
Mailing Address: | 110 Village Ln Suite 2b Fairfield Bay |
State: | AR US |
Postal Code: | 72088 |
Phone Number: | 5018873212 |
Fax Number: | |
NPI Enumeration Date: | 05/06/2014 |
NPI Last Update Date: | 10/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |