OrganizationActive
Southeast Rehab LLC
NPI 1942658729 · Adult Medicine Physician · Lake Village, AR
Provider details
- NPI number
- 1942658729
- Entity type
- Organization
- Primary specialty
- Adult Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Cathy Waldrop, Chairman(318) 665-9950
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Medical Physician Assistant363AM0700X
Physician Assistants & Advanced Practice Nursing Providers
- Adult Health Nurse Practitioner363LA2200X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
903 Borgognoni Dr
Lake Village, AR 71653-1623
Phone: (870) 265-4333
Fax: (318) 665-0379
Approximate (ZIP-level) locationGet directions
Mailing address
903 Borgognoni Dr
Lake Village, AR 71653-1623
Other names (DBA / former)
- Doing business as
- Southeast Rehabilitation Hospital
Registry dates
- Enumerated
- 2016-06-02
- Last updated
- 2019-06-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.