Organization
SUDESH BANAJI MD PLLC
Active
Other names
Earle Family Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SUDESH BANAJI MD (OWNER)
(870) 792-8825
Entity
Organization
Contact information
Practice address
1605 SECOND STREET, EARLE, AR 72331-1634
(870) 792-8825
(870) 792-8834
Mailing address
332 E COOK ST, FORREST CITY, AR 72335-2830
(870) 630-2233
(870) 630-2224
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
E2405
AR
Other
Enumeration date
03/06/2009
Last updated
05/16/2014
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