Organization
DE QUEEN MEDICAL CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRAMY ICENHOWER RN, BSN (ADMINISTRATOR)
(870) 584-0272
Entity
Organization
Contact information
Practice address
1314 W COLLIN RAYE DR, DE QUEEN, AR 71832-2135
(870) 642-2273
(870) 642-2162
Mailing address
1306 W COLLIN RAYE DR, DE QUEEN, AR 71832-2502
(870) 584-4111
(870) 584-4100
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/28/2017
Last updated
06/28/2017
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