Deyoung, Bruce D

Deyoung, Bruce D is an individual health care provider with primary practice located at 1109 S West End St , Springdale AR 72764. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Deyoung, Bruce D can be contacted via phone (479) 750-3630.

Contact Information

Primary practice address
1109 S West End St Springdale AR 72764
Phone: (479) 750-3630
Fax: (479) 751-3308
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X C-8115 Arkansas

Profile Details

NPI number 1144294299
LBN Legal business name Deyoung, Bruce D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Dec 21st, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144294299 NPPES
Arkansas Other 56557 AR BC/BS
Arkansas MEDICAID 125013001 AR BC/BS

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