Organization
PREMIER RURAL DB & GANTT SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIAN IMRAN AHMED (ADMINISTRATOR)
(870) 875-1481
Entity
Organization
Contact information
Practice address
403 W. OAK STREET, SUITE 101, EL DORADO, AR 71730-4573
(870) 875-1481
(870) 875-1486
Mailing address
403 W. OAK STREET, SUITE 101, EL DORADO, AR 71730-4573
(870) 875-1481
(870) 875-1486
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
06/20/2024
Last updated
06/20/2024
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