Organization
DEBRA FAULKNER
Active
Other names
Port X Medical Services
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA KAY FAULKNER R.T. (OWNER)
(870) 862-2000
Entity
Organization
Contact information
Practice address
532 W FAULKNER ST, EL DORADO, AR 71730-4519
(870) 862-2000
Mailing address
532 W FAULKNER ST, EL DORADO, AR 71730-4519
(870) 862-2000
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140983710
—
AR
Enumeration date
10/26/2007
Last updated
06/17/2008
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