Declerk Family Medicine, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DECLERK FAMILY MEDICINE, PLLC

Practice address

4305 S Pleasant Crossing Blvd Ste 103
Rogers, AR 72758-1347

Phone

(479) 302-1020

NPI assigned

Sep 18, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

George Ryan Declerk

Title

Manager

Phone

(479) 422-3647

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1789689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789689600000",
    "number": "1366354938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2261 N CENTER ST",
            "city": "GENTRY",
            "state": "AR",
            "postal_code": "727346022",
            "telephone_number": "479-422-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 S PLEASANT CROSSING BLVD STE 103",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581347",
            "telephone_number": "479-302-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECLERK FAMILY MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-18",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A",
        "authorized_official_last_name": "DECLERK",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "479-422-3647"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Rogers, AR
• Providers in Rogers, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.