Organization
CHICOT MEMORIAL HOSPITAL ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE A BENNETT (CEO)
(870) 265-5351
Entity
Organization
Contact information
Practice address
2729 HWY 65 & 82 SOUTH, LAKE VILLAGE, AR 71653
(870) 265-5351
(870) 265-3910
Mailing address
2729 HWY 65 & 82 SOUTH, LAKE VILLAGE, AR 71653
(870) 265-5351
(870) 265-3910
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
AR4314
AR
367500000X
Certified Registered Nurse Anesthetist
AR3934
AR
Other
Enumeration date
11/15/2006
Last updated
09/11/2025
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