# BAXTER COUNTY REGIONAL HOSPITAL, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Baxter Health College Street Family Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316777329
- **Authorized official:** DEBRA HENRY (CFO)
- **Authorized official phone:** (870) 508-1003

## Contact information

- **Practice address:** 400 S COLLEGE ST STE 5, MOUNTAIN HOME, AR 72653-3923
- **Practice address phone:** (870) 508-1000
- **Mailing address:** 400 S COLLEGE ST STE 5, MOUNTAIN HOME, AR 72653-3923
- **Mailing address phone:** (870) 508-1000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/05/2024
- **Last updated:** 08/05/2024