MOUNTAIN HOME SURGERY CENTER NPI 1205978780

NPI Information

NPI: 1205978780
Provider Name: MOUNTAIN HOME SURGERY CENTER
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
360 HIGHWAY 5 N
MOUNTAIN HOME, AR
ZIP 72653
Phone: (870) 425-2277
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MOUNTAIN HOME SURGERY CENTER is an ambulatory surgical clinic center in Mountain Home, AR. MOUNTAIN HOME SURGERY CENTER NPI is 1205978780. The provider is registered as an organization entity type.

The provider's business location address is:

360 HIGHWAY 5 N
MOUNTAIN HOME, AR
ZIP 72653-039
Phone: (870) 425-2277
Fax: (870) 425-2021

The provider's authorized official is Kenneth Allan Jones .
The authorized official title is President and has the following contact phone number (870) 425-2277.

The enumeration date for this NPI number is 2/13/2007 and was last updated on 2/8/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	2345	ARKANSAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	194829128	MEDICAID	ARKANSAS
2	2345	OTHER	ARKANSAS	STATE LICENSE NUMBER
3	11017	MEDICARE PIN	ARKANSAS
4	118386128	MEDICAID	ARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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