Organization
FOOT CARE OF NORTHEAST ARKANSAS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDDY LLOYD CALDWELL DPM (PRESIDENT)
(870) 933-8900
Entity
Organization
Contact information
Practice address
406 E WASHINGTON AVE, JONESBORO, AR 72401-3108
(870) 933-8900
(870) 933-2611
Mailing address
PO BOX 1984, JONESBORO, AR 72403-1984
(870) 933-8900
(870) 933-2611
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
AR163
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130246748
—
AR
05
—
167681748
—
AR
01
—
16888000000
QUALCHOICE
—
01
—
480034780
RR MEDICARE
—
01
—
5F963
MEDICARE
AR
01
—
5T344
BCBS
—
Enumeration date
02/27/2008
Last updated
08/28/2008
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