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Individual

AMY DELUCA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
353 CASH ROAD SW, CAMDEN, AR 71701
(870) 836-8101
Mailing address
PO BOX 757, CAMDEN, AR 71701-0757

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E5045
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000271510402
UNITED HEALTH CARE
01
06100017100
QUALCHOICE
05
162343001
AR
01
7152880
AETNA
01
771063201
BREASTCARE
AR
01
P00386226
MEDICARE RAILROAD
Enumeration date
10/04/2006
Last updated
10/03/2008
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