Provider Demographics
NPI:1306500129
Name:DOCTORS ORDERS INFUSION SERVICES
Entity type:Organization
Organization Name:DOCTORS ORDERS INFUSION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO
Authorized Official - Prefix:
Authorized Official - First Name:LELAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-218-1718
Mailing Address - Street 1:2302 W 28TH AVE STE D
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-5050
Mailing Address - Country:US
Mailing Address - Phone:870-218-1718
Mailing Address - Fax:870-218-4971
Practice Address - Street 1:2302 W 28TH AVE STE D
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-5050
Practice Address - Country:US
Practice Address - Phone:870-218-1718
Practice Address - Fax:870-218-4971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty