Organization
JT DEWITT D.O.P.A.
Active
Other names
DeWitt Family Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JT DEWITT JR. D.O. (CEO)
(870) 897-8433
Entity
Organization
Contact information
Practice address
11998 HIGHWAY 49 N, MARMADUKE, AR 72443-9597
(870) 897-8433
(870) 897-8438
Mailing address
3071 HIGHWAY 34 E, MARMADUKE, AR 72443-9773
(870) 897-8433
(870) 897-8438
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
E4975
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175408003
—
AR
Enumeration date
03/24/2014
Last updated
03/24/2014
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