1336417823 NPI number — FRANKLIN LLOYD JONES

Table of content: FRANKLIN LLOYD JONES (NPI 1336417823)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336417823 NPI number — FRANKLIN LLOYD JONES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
FRANKLIN
Provider Middle Name:
LLOYD
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336417823
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7509 CANTRELL RD STE 205
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITTLE ROCK
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72207-2500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-725-0021
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1719 MERRILL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LITTLE ROCK
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72212-4009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-663-2199
Provider Business Practice Location Address Fax Number:
501-663-2234
Provider Enumeration Date:
12/12/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  P2007032 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 241370719 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com