| Cdu, Pllc | |
|
1600 W 42nd Ave Pine Bluff AR 71603-7006 | |
| (870) 541-7111 | |
| (870) 850-6482 |
| Full Name | Cdu, Pllc |
|---|---|
| Speciality | General Practice |
| Location | 1600 W 42nd Ave, Pine Bluff, Arkansas |
| Authorized Official Name and Position | John Theodore Skowronski (PRESIDENT) |
| Authorized Official Contact | 8708506053 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cdu, Pllc 316 W 6th Ave Pine Bluff AR 71601-4217 Ph: (870) 850-6053 | Cdu, Pllc 1600 W 42nd Ave Pine Bluff AR 71603-7006 Ph: (870) 541-7111 |
| NPI Number | 1114283694 |
|---|---|
| Provider Enumeration Date | 04/09/2012 |
| Last Update Date | 04/13/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114283694 | NPI | - | NPPES |
| PENDING | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (Arkansas) | Primary |
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