Individual
JEFFERY DEOIN ANGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 VIRGINIA DR, SUITE C, BATESVILLE, AR 72501-7331
(870) 793-2371
(870) 793-7585
Mailing address
501 VIRGINIA DR, SUITE C, BATESVILLE, AR 72501-7331
(870) 793-2371
(870) 793-7585
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
C-7451
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114937001
—
AR
01
—
200016406
PALMETTO GBA RAILROAD
AR
01
—
248030
HEALTHLINK
AR
01
—
523277052
MEDICARE - TYPE UNSPECIF
—
01
—
A004
TRICARE
AR
Enumeration date
04/21/2006
Last updated
02/16/2017
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