Organization
DE QUEEN PEDIATRICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI A DEVLIN M.D. (OWNER/PHYSICIAN)
(870) 642-4364
Entity
Organization
Contact information
Practice address
1357 W COLLIN RAYE DR, DE QUEEN, AR 71832-2946
(870) 642-4364
Mailing address
1357 W COLLIN RAYE DR, DE QUEEN, AR 71832-2946
(870) 642-4364
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
E-2169
AR
208D00000X
General Practice Physician
E-2169
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170952002
—
AR
Enumeration date
09/03/2008
Last updated
04/24/2014
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