Individual
LOREN DEPUTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
408 N 1ST ST, GLENWOOD, AR 71943-9250
(870) 356-1556
Mailing address
408 N 1ST ST STE C, GLENWOOD, AR 71943-9252
(870) 356-1556
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
E13053
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2017
Last updated
10/14/2020
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