Organization
MENA SURGICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY QUEBEDEAUX (CEO)
(479) 394-6100
Entity
Organization
Contact information
Practice address
400 CRESTWOOD CIR STE L, MENA, AR 71953-5512
(479) 243-2103
(479) 243-2468
Mailing address
PO BOX 1325, MENA, AR 71953-1325
(479) 243-2103
(479) 243-2468
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
E0207
AR
Other
Enumeration date
12/16/2008
Last updated
10/27/2016
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