# SUDESH BANAJI MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Earle Family Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639319411
- **Authorized official:** MR. SUDESH BANAJI MD (OWNER)
- **Authorized official phone:** (870) 792-8825

## Contact information

- **Practice address:** 1605 SECOND STREET, EARLE, AR 72331-1634
- **Practice address phone:** (870) 792-8825
- **Practice address fax:** (870) 792-8834
- **Mailing address:** 332 E COOK ST, FORREST CITY, AR 72335-2830
- **Mailing address phone:** (870) 630-2233
- **Mailing address fax:** (870) 630-2224

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | E2405 | AR | Yes |

## Other

- **Enumeration date:** 03/06/2009
- **Last updated:** 05/16/2014