Provider Demographics
NPI:1306921747
Name:STUTTGART REGIONAL MEDICAL CENTER
Entity type:Organization
Organization Name:STUTTGART REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-673-3511
Mailing Address - Street 1:1701 NORTH BUERKLE
Mailing Address - Street 2:
Mailing Address - City:STUTTGART
Mailing Address - State:AR
Mailing Address - Zip Code:72160-1905
Mailing Address - Country:US
Mailing Address - Phone:870-673-3511
Mailing Address - Fax:870-672-6869
Practice Address - Street 1:1701 N BUERKLE ROAD
Practice Address - Street 2:
Practice Address - City:STUTTGART
Practice Address - State:AR
Practice Address - Zip Code:72160-1905
Practice Address - Country:US
Practice Address - Phone:870-673-3511
Practice Address - Fax:870-672-6869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR3903282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR10094105Medicaid
AR10072OtherBLUE CROSS
AR10072OtherBLUE CROSS