# LANSDELL ENTERPRISE CORP

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

## Provider details

- **NPI number:** 1487278776
- **Authorized official:** MICHAEL LANSDELL (OWNER)
- **Authorized official phone:** (870) 584-1055

## Contact information

- **Practice address:** 500 E COLLIN RAYE DR, DE QUEEN, AR 71832-8048
- **Practice address phone:** (870) 584-1055
- **Mailing address:** 500 E COLLIN RAYE DR, DE QUEEN, AR 71832-8048
- **Mailing address phone:** (870) 584-1055

## Taxonomy

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