Individual
JEREMY C FUNDERBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
217 S JEFFERSON AVE STE 100, EL DORADO, AR 71730-5900
(870) 862-7984
(870) 863-5154
Mailing address
217 S JEFFERSON AVE STE 100, EL DORADO, AR 71730-5900
(870) 862-7984
(870) 863-5154
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/06/2009
Last updated
07/06/2009
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