Individual
DR. MICKEY BRIAN DEEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
225 E JACKSON ST, JONESBORO, AR 72401
(870) 207-4100
Mailing address
225 E JACKSON STREET, JONESBORO, AR 72401
(870) 207-4100
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
E-6585
AR
207Q00000X
Family Medicine Physician
0102201763
VA
207Q00000X
Family Medicine Physician
Primary
E-6585
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190261003
—
AR
Enumeration date
01/21/2006
Last updated
07/18/2017
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