David C Jacks Md Pa

LBN: David C Jacks Md Pa
David C Jacks Md Pa is an health care organization with primary practice located at 4303 S Mulberry St , Pine Bluff AR 71603-7017. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. David C Jacks Md Pa can be contacted via phone (870) 535-4221, or through Frizielle, Judy via phone (870) 535-4221.

Contact Information

Primary practice address
4303 S Mulberry St Pine Bluff AR 71603-7017
Phone: (870) 535-4221
Fax: (870) 535-4228
Website:
Map and Directions
Authorized official contact:
Name: Frizielle, Judy Licensed Practical Nurse (LPN)
Phone: (870) 535-4221

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X C5066 Arkansas

Profile Details

NPI number 1083882633
LBN Legal business name David C Jacks Md Pa
DBA Doing business as
Authorized official Frizielle, Judy Licensed Practical Nurse (LPN)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 18th, 2008
Last updated Nov 15th, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083882633 NPPES
Arkansas MEDICAID 104930001

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