# DEBRA FAULKNER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Portable Imaging
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265620868
- **Authorized official:** MS. DEBRA KAY FAULKNER R.T. (OWNER)
- **Authorized official phone:** (870) 310-0321

## Contact information

- **Practice address:** 3025 N WYATT DR, EL DORADO, AR 71730-4189
- **Practice address phone:** (870) 310-0321
- **Practice address fax:** (870) 862-2074
- **Mailing address:** 3025 N WYATT DR, EL DORADO, AR 71730-4189
- **Mailing address phone:** (870) 310-0321
- **Mailing address fax:** (870) 862-2074

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 10/09/2007
- **Last updated:** 08/30/2010