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Organization
NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC.
Active
Organization
NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC.
Active
Other names
Fowler Family Center for Cancer Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY M. DUCKETT (SR. VP / CORPORATE SECRETARY)
(901) 227-5233
Entity
Organization
Contact information
Practice address
4808 E JOHNSON AVE, JONESBORO, AR 72401-8413
(870) 936-8000
(870) 932-3608
Mailing address
PO BOX 1960, JONESBORO, AR 72403-1960
(870) 336-1485
(870) 336-1484
Taxonomy
Speciality
Code
Description
License number
State
261QX0200X
Oncology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184473002
—
AR
01
—
5G237
BCBS
AR
Enumeration date
12/31/2013
Last updated
09/29/2020
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