MEDICARE: DR. JOSEPH WILLIAM QUEENEY D.O.

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
1	207T00000X	Neurological Surgery Physician	E-1116	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811919160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH WILLIAM QUEENEY D.O.

Provider Business Mailing Address
First Line	:	PO BOX 11230
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72917-1230
Country	:	US
Telephone Number	:	479-709-6700
Fax Number	:	479-709-6709

Provider Business Practice Location Address
First Line	:	3501 WE KNIGHT DR
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-6248
Country	:	US
Telephone Number	:	479-709-6700
Fax Number	:	479-709-6709

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	07/21/2020

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Directions to “ DR. JOSEPH WILLIAM QUEENEY D.O.” Practice Location

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