Provider Demographics
NPI:1316929045
Name:GUY J L'HEUREUX MD PA
Entity type:Organization
Organization Name:GUY J L'HEUREUX MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:GUY
Authorized Official - Middle Name:J
Authorized Official - Last Name:L'HEUREUX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-735-4025
Mailing Address - Street 1:228 W TYLER AVE
Mailing Address - Street 2:STE 105
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-4089
Mailing Address - Country:US
Mailing Address - Phone:870-735-4025
Mailing Address - Fax:870-735-0570
Practice Address - Street 1:228 W TYLER AVE
Practice Address - Street 2:STE 105
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-4089
Practice Address - Country:US
Practice Address - Phone:870-735-4025
Practice Address - Fax:870-735-0570
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRITTENDEN HOSPITAL ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-11-17
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR2758207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR101978001Medicaid
0145620001OtherPALMETTO
AR14086000000OtherQUALCHOICE
2582086OtherAETNA
AR101978001Medicaid