Organization
LEE A FORESTIERE MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE BOGY (OFFICE MANAGER)
(870) 534-4188
Entity
Organization
Contact information
Practice address
1609 W 40TH AVE STE 403, PINE BLUFF, AR 71603-6365
(870) 534-4188
(870) 534-7964
Mailing address
1609 W 40TH AVE STE 403, PINE BLUFF, AR 71603-6365
(870) 534-4188
(870) 534-7964
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
C4813
AR
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103036001
—
AR
Enumeration date
01/06/2010
Last updated
10/20/2020
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