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Organization
DECLERK FAMILY MEDICINE, PLLC
Active
Organization
DECLERK FAMILY MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE RYAN DECLERK (MANAGER)
(479) 422-3647
Entity
Organization
Contact information
Practice address
4305 S PLEASANT CROSSING BLVD STE 103, ROGERS, AR 72758-1347
(479) 302-1020
Mailing address
2261 N CENTER ST, GENTRY, AR 72734-6022
(479) 422-3647
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/18/2026
Last updated
09/18/2026
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