# LITTLE RIVER MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Little River Memorial Hospital Emergency Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457353914
- **Authorized official:** MR. DAVID DEATON (CEO)
- **Authorized official phone:** (870) 898-5011

## Contact information

- **Practice address:** 451 W LOCKE ST, ASHDOWN, AR 71822-3325
- **Practice address phone:** (870) 898-5011
- **Practice address fax:** (870) 898-4172
- **Mailing address:** 451 W LOCKE ST, ASHDOWN, AR 71822-3325
- **Mailing address phone:** (870) 898-5011
- **Mailing address fax:** (870) 898-4172

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | AR4204 | AR | Yes |

## Other

- **Enumeration date:** 08/15/2005
- **Last updated:** 05/03/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100699110B | — | OK |
| 05 | — | 103216002 | — | AR |
| 05 | — | 108625801 | — | TX |
| 01 | — | 57601 | BCBS ER PHYS GRP\# | AR |