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Organization
MAGNOLIA SURGERY CENTER, LLC
Active
Organization
MAGNOLIA SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IVORY A KINSLOW (OWNER/MEDICAL DIRECTOR)
(870) 234-5665
Entity
Organization
Contact information
Practice address
25 COLUMBIA ROAD 47, MAGNOLIA, AR 71753
(870) 234-5665
(870) 234-5665
Mailing address
25 COLUMBIA ROAD 47, MAGNOLIA, AR 71753
(870) 234-5665
(879) 234-5665
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
295574
MEDICARE PTAN
AR
Enumeration date
07/20/2012
Last updated
08/20/2025
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