Organization
CHICOT MEMORIAL MEDICAL CENTER
Active
Parent organization
CHICOT MEMORIAL MEDICAL CENTER
Other names
Chicot Memorial Medical Center Dental Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHICOT MEMORIAL MEDICAL CENTER
Authorized official
SUSAN VAUGHN (CFO)
(870) 265-9229
Entity
Organization
Contact information
Practice address
2729 S. HWY 65 82, LAKE VILLAGE, AR 71653
(870) 265-5351
Mailing address
2729 S HIGHWAY 65 82, LAKE VILLAGE, AR 71653-6136
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/20/2017
Last updated
06/16/2018
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