# DE QUEEN FAMILY MEDICAL ASSOCIATES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104678820
- **Authorized official:** WILLIAM H. KELLEY MD (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (870) 584-3627

## Contact information

- **Practice address:** 500 E COLLIN RAYE DR, DE QUEEN, AR 71832-8048
- **Practice address phone:** (870) 584-3627
- **Mailing address:** 500 E COLLIN RAYE DR, DE QUEEN, AR 71832-8048

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/04/2024
- **Last updated:** 05/31/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 319492002 | — | AR |