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Organization

BOARD OF GOVERNORS OF DALLAS COUNTY MEDICAL CENTER

Active
Other names
Nutt-Walley Clinic of Dallas County Medical Center
Organization subpart
No

Provider details

NPI number
Authorized official
KENNETH E SANDERS (ADMINISTRATOR)
(870) 352-6363
Entity
Organization

Contact information

Practice address
110 N CLIFTON ST, FORDYCE, AR 71742-3025
(870) 352-3525
(870) 352-3533
Mailing address
110 N CLIFTON ST, FORDYCE, AR 71742-3025

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
261QR1300X
Rural Health Clinic/Center
Primary

Other

Enumeration date
01/29/2018
Last updated
01/29/2018
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