Individual
DR. BRUCE D DEYOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1109 S WEST END ST, SPRINGDALE, AR 72764
(479) 750-3630
(479) 751-3308
Mailing address
PO BOX 1523, FAYETTEVILLE, AR 72702-1523
(479) 571-6038
(479) 582-0222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C-8115
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125013001
—
AR
01
—
56557
AR BC/BS
AR
Enumeration date
02/15/2006
Last updated
12/21/2021
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