Organization
DOCTORS' PATHOLOGY SERVICES, PA
Active
Other names
Arkansas Anatomic Pathology Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN WAYNE LOCKE M.D. (PRESIDENT)
(870) 930-3518
Entity
Organization
Contact information
Practice address
411 E MATTHEWS AVE, JONESBORO, AR 72401-3142
(870) 930-3518
(870) 930-3569
Mailing address
PO BOX 1916, JONESBORO, AR 72403-1916
(870) 930-3518
(870) 930-3569
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101694709
—
AR
01
—
18016
BCBS GROUP PROVIDER #
AR
01
—
690005348
RAILROAD GROUP PROVIDER #
AR
05
—
701094401
—
MO
Enumeration date
07/21/2006
Last updated
06/16/2008
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