Individual
GEORGE RYAN DECLERK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2603 W PLEASANT GROVE RD, SUITE 109, ROGERS, AR 72758-5804
(479) 636-4138
(479) 636-4140
Mailing address
2603 W PLEASANT GROVE RD, SUITE 109, ROGERS, AR 72758-5804
(479) 636-4138
(479) 636-4140
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E5450
AR
Other
Enumeration date
05/31/2007
Last updated
09/09/2020
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