Individual
DR. S KILLEEN DESLAURIERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11825 HINSON RD, SUITE 101, LITTLE ROCK, AR 72212-3404
(501) 221-1050
(501) 221-2967
Mailing address
11825 HINSON RD, SUITE 101, LITTLE ROCK, AR 72212-3404
(501) 221-1050
(501) 221-2967
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C5186
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51369
BC/BS
AR
Enumeration date
07/30/2006
Last updated
07/08/2007
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