Organization
CR DOC,PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER EARL CAGLE M.D. (OWNER)
(870) 239-3600
Entity
Organization
Contact information
Practice address
2700 W KINGSHIGHWAY, SUITE 4, PARAGOULD, AR 72450-2601
(870) 239-3600
(870) 240-0643
Mailing address
2700 W KINGSHIGHWAY, SUITE 4, PARAGOULD, AR 72450-2601
(870) 239-3600
(870) 240-0643
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C5380
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5C936
ABCBS PROVIDER NUMBER
AR
Enumeration date
02/14/2007
Last updated
05/20/2014
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