BOARD OF GOVERNORS OF DALLAS COUNTY MEDICAL CENTER NPI 1508364241

NPI Information

BOARD OF GOVERNORS OF DALLAS COUNTY MEDICAL CENTER is a rural health clinic center in Fordyce, AR. BOARD OF GOVERNORS OF DALLAS COUNTY MEDICAL CENTER NPI is 1508364241. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Nutt-walley Clinic Of Dallas County Medical Center.

The provider's business location address is:

110 N CLIFTON ST
FORDYCE, AR
ZIP 71742-025
Phone: (870) 352-3525
Fax: (870) 352-3533

The provider's authorized official is Kenneth E Sanders .
The authorized official title is Administrator and has the following contact phone number (870) 352-6363.

The CLIA number assigned to this NPI record is 04D1089243 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/29/2018 and was last updated on 1/29/2018.

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:

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