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Organization
NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC.
Active
Organization
NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC.
Active
Other names
NEA Baptist Mobile Health Unit
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY M DUCKETT SR. VP/CLO (SR VP/CHIEF LEGAL OFFICER)
(901) 227-5233
Entity
Organization
Contact information
Practice address
4800 E JOHNSON AVE, JONESBORO, AR 72405-8413
(870) 936-8000
Mailing address
350 N HUMPHREYS BLVD, MEMPHIS, TN 38120-2177
(901) 227-5233
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
NULL
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
261QP2300X
Primary Care Clinic/Center
—
NULL
261QR0207X
Mobile Mammography Clinic/Center
Primary
—
NULL
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
11/08/2023
Last updated
11/08/2023
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