Bardella, Inis Jane
Bardella, Inis Jane is an individual health care provider with primary practice located at 1617 N Washington , Magnolia AR 71753-2046. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Bardella, Inis Jane can be contacted via phone (870) 562-2588.Contact Information
Primary practice address
1617 N Washington
Magnolia AR 71753-2046
Phone: (870) 562-2588
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | E-12712 | Arkansas |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036129581 | Illinois |
Profile Details
| NPI number | 1124084926 |
|---|---|
| LBN Legal business name | Bardella, Inis Jane |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 21st, 2006 |
| Last updated | Oct 27th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124084926 | NPPES |
| Indiana | MEDICAID | 200496730 | |
| Indiana | MEDICAID | PENDING | |
| Indiana | Other | 036129581 |
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