De Queen Medical Center, INC

NPI #1124549316 in De Queen, Arkansas

Provider Information

NPI Number: 1124549316
Entity Type: Organization
Organization Name: De Queen Medical Center, INC
Primary Specialty: Clinic/Center - Primary Care
Enumeration Date: Jun 28, 2017
Last Updated: Jun 28, 2017

Practice Location

Address: 1314 W COLLIN RAYE DR
City: De Queen
State: Arkansas
ZIP Code: 71832-2135
Phone: (870) 642-2273

Authorized Official

Name: MR. JERRAMY ICENHOWER, RN, BSN
Title: ADMINISTRATOR
Phone: (870) 584-0272

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Primary Care — Primary Care	261QP2300X	Primary

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