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General NPI Number Information
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NPI Number | 1417969478
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Entity Type | Individual
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Provider Name | JOSEPH A DELUCA MD
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Gender | Male
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 620 W GROVE ST STE 202
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City | EL DORADO
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State | AR
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Zip | 71730-4425
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Country | US
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Telephone | 870-234-7676
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Fax | 870-562-2560
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Provider Business Mailing Address
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Address Line | 620 W GROVE ST STE 202
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City | EL DORADO
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State | AR
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Zip | 71730-4425
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Country | US
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Telephone | 870-234-7676
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Fax | 870-562-2560
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | E4974
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | E-4974
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License Number State | AR
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