Provider Demographics
NPI:1164851291
Name:D FURR MEDICINE INC PA
Entity Type:Organization
Organization Name:D FURR MEDICINE INC PA
Other - Org Name:IMAGE QUEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:FURR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:479-365-2355
Mailing Address - Street 1:5203 WILLOW CREEK DRIVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:JOHNSON
Mailing Address - State:AR
Mailing Address - Zip Code:72741-0000
Mailing Address - Country:US
Mailing Address - Phone:479-365-2355
Mailing Address - Fax:
Practice Address - Street 1:5203 WILLOW CREEK DR
Practice Address - Street 2:SUITE 2
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-0876
Practice Address - Country:US
Practice Address - Phone:479-365-2355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-3777207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty