Organization
DOCTORS' PATHOLOGY SERVICES, PA
Active
Other names
Arkansas Anatomic Pathology Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN WAYNE LOCKE M.D. (PRESIDENT)
(870) 930-3518
Entity
Organization
Contact information
Practice address
411 E MATTHEWS AVE, JONESBORO, AR 72401
(870) 930-3518
(870) 930-3569
Mailing address
P O BOX 1916, JONESBORO, AR 72403
(870) 930-3518
(870) 930-3569
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101694709
—
AR
01
—
56724
BCBS GROUP PROVIDER #
AR
01
—
690005348
RAILROAD MEDICARE
AR
01
—
CS0204
RAILROAD MEDICARE
—
Enumeration date
10/12/2006
Last updated
06/16/2008
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