Organization
NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC.
Active
Other names
NEA Baptist Mobile Health Unit
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY M DUCKETT SR. VP/CLO (SR VP/CHIEF LEGAL OFFICER)
(901) 227-5233
Entity
Organization
Contact information
Practice address
4800 E JOHNSON AVE, JONESBORO, AR 72405-8413
(870) 936-8000
Mailing address
350 N HUMPHREYS BLVD, MEMPHIS, TN 38120-2177
(901) 227-5233
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR0207X
Mobile Mammography Clinic/Center
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
11/08/2023
Last updated
11/08/2023
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