Organization
BOARD OF GOVERNORS OF DALLAS COUNTY MEDICAL CENTER
Active
Other names
Dallas County Medical Center Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA K RIEVES (ADMINISTRATOR / CEO)
(870) 352-6363
Entity
Organization
Contact information
Practice address
201 NORTH CLIFTON STREET, FORDYCE, AR 71742
(870) 352-6363
(870) 352-6343
Mailing address
201 NORTH CLIFTON STREET, FORDYCE, AR 71742
(870) 352-6363
(870) 352-6343
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
AR4115
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148217105
—
AR
Enumeration date
03/01/2007
Last updated
08/12/2016
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