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Organization
LANSDELL ENTERPRISE CORP
Active
Organization
LANSDELL ENTERPRISE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL LANSDELL (OWNER)
(870) 584-1055
Entity
Organization
Contact information
Practice address
500 E COLLIN RAYE DR, DE QUEEN, AR 71832-8048
(870) 584-1055
Mailing address
500 E COLLIN RAYE DR, DE QUEEN, AR 71832-8048
(870) 584-1055
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
363LA2200X
Adult Health Nurse Practitioner
—
NULL
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
NULL
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Enumeration date
06/02/2020
Last updated
06/02/2020
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