Organization
JERRY L HARVEY, DO, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY HARVEY D.O. (PRESIDENT)
(501) 605-9355
Entity
Organization
Contact information
Practice address
15361 HIGHWAY 5, SUITE E, CABOT, AR 72023-5128
(501) 605-9355
Mailing address
15361 HIGHWAY 5, SUITE E, CABOT, AR 72023-5128
(501) 605-9355
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125608003
—
AR
01
—
5J444
MEDICARE ID-TYPE UNSPECIFIED
AR
Enumeration date
06/25/2009
Last updated
06/25/2009
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