Dennis W Jacks M.D.

NPI 1013909316 - Specialist - 174400000X

NPI Details
NPI 1013909316
Gender Male
Enumeration Date 08/22/2005
Last Updated 09/16/2011
Entity Type Individual
Active Over 11 years ago
Practice Location
1609 W 40TH AVE
STE 301
PINE BLUFF AR, 71603-6329, US
Phone (870) 536-5162
Fax (870) 536-5198
Business Location
1609 W 40TH AVE
STE 301
PINE BLUFF AR, 71603-6329, US
Phone (870) 536-5162
Fax (870) 536-5198
Toxanomy
Taxonomy Code 174400000X
License State Arkansas
License Number C5724
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According to our database, Dr. Dennis W Jacks M.D. NPI is 1013909316, taxonomy code is 174400000X and license number is C5724, license state is located at Arkansas. Dennis W Jacks M.D. physically located at 1609 W 40th Ave, Pine Bluff AR, 71603-6329. NPI Number Dennis W Jacks M.D. has the Individual type.

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1013909316 NPI number is provided on an as is basis without warranty of any kind. 1013909316 is maintained by the National Plan & Provider Enumeration System. The contents of Dennis W Jacks M.D. are for informational purposes only.