| Baxter County Regional Hospital, Inc | |
|
1417 Gladden St Harrison AR 72601-2236 | |
| (870) 741-0016 | |
| Not Available |
| Full Name | Baxter County Regional Hospital, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1417 Gladden St, Harrison, Arkansas |
| Authorized Official Name and Position | Lucinda Crow (SYSTEM DATA ANALYST) |
| Authorized Official Contact | 8705081081 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baxter County Regional Hospital, Inc 1417 Gladden St Harrison AR 72601-2236 Ph: (870) 741-0016 | Baxter County Regional Hospital, Inc 1417 Gladden St Harrison AR 72601-2236 Ph: (870) 741-0016 |
| NPI Number | 1144908351 |
|---|---|
| Provider Enumeration Date | 07/07/2023 |
| Last Update Date | 07/07/2023 |
| Medicare PECOS PAC ID | 0042389264 |
|---|---|
| Medicare Enrollment ID | O20211124000016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144908351 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Victor S Chu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528039443 PECOS PAC ID: 8729090568 Enrollment ID: I20060620000036 |
| Provider Name | Kevin T Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144291907 PECOS PAC ID: 4183636921 Enrollment ID: I20060620000066 |
| Provider Name | Fredric L Fredlund |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619470903 PECOS PAC ID: 5890058408 Enrollment ID: I20180412002782 |
| Provider Name | Amanda J Winford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316433998 PECOS PAC ID: 2264782549 Enrollment ID: I20180906003385 |
| Provider Name | Jason L Froeschle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265038848 PECOS PAC ID: 3173937521 Enrollment ID: I20210127001173 |
| Provider Name | Kimberly Martin Cudworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760155121 PECOS PAC ID: 7911398649 Enrollment ID: I20220106001376 |
| Provider Name | Candice M Scarpa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407529878 PECOS PAC ID: 6103273248 Enrollment ID: I20231110000070 |
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