Organization
MEDICAL ASSOCIATES PA LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN D DEDMAN M.D. (OWNER)
(870) 535-2200
Entity
Organization
Contact information
Practice address
4201 S MULBERRY ST, PINE BLUFF, AR 71603-7016
(870) 535-2200
(870) 535-2208
Mailing address
4201 S MULBERRY ST, PINE BLUFF, AR 71603-7016
(870) 535-2200
(870) 535-2208
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18066
ARK BLUE CROSS BLUE SHIEL
AR
Enumeration date
01/12/2007
Last updated
08/22/2020
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