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NPI Code Detail

MEDICARE: DOCTORS' ANATOMIC PATHOLOGY SERVICES, PA

MEDICARE: DOCTORS' ANATOMIC PATHOLOGY SERVICES, PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianAR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15B433OTHERARBCBS PROVIDER NUMBER

General Provider Information

NPI Number : 1699781096
Entity Type Code : Organization
Provider Name (Legal Business Name) : DOCTORS' ANATOMIC PATHOLOGY SERVICES, PA
Provider Business Mailing Address
First Line : PO BOX 1326
Second Line :
City : JONESBORO
State : AR
Zip : 72403-1326
Country : US
Telephone Number : 870-930-3518
Fax Number : 870-930-3569
Provider Business Practice Location Address
First Line : 3024 STADIUM BLVD
Second Line :
City : JONESBORO
State : AR
Zip : 72401-7415
Country : US
Telephone Number : 870-930-3518
Fax Number : 870-930-3569
Authorized Official
Title or Position : PRESIDENT
Name : STEPHEN WAYNE LOCKE
Credential : M.D.
Telephone Number : 870-930-3518
Provider Enumeration Date : 07/31/2006
Last Update Date : 08/22/2020

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Directions to “DOCTORS' ANATOMIC PATHOLOGY SERVICES, PA ” Practice Location

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