Provider Demographics
NPI:1124299599
Name:DIGESTIVE CARE PA
Entity type:Organization
Organization Name:DIGESTIVE CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:STUCKS
Authorized Official - Suffix:
Authorized Official - Credentials:ETC
Authorized Official - Phone:870-534-5533
Mailing Address - Street 1:PO BOX 2797
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71613-2797
Mailing Address - Country:US
Mailing Address - Phone:870-534-5533
Mailing Address - Fax:870-534-5535
Practice Address - Street 1:14918 CANTRELL RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-4248
Practice Address - Country:US
Practice Address - Phone:501-663-4747
Practice Address - Fax:501-663-4757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR4495207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty