Davis, Jim Glenn

Davis, Jim Glenn is an sole proprietor health care provider with primary practice located at 502 Greening St Suite 3C, Camden AR 71701-3491. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Davis, Jim Glenn can be contacted via phone (870) 837-4065.

Contact Information

Primary practice address
502 Greening St Suite 3C Camden AR 71701-3491
Phone: (870) 837-4065
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X C00332 Arkansas
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X C000332 Arkansas

Profile Details

NPI number 1780808196
LBN Legal business name Davis, Jim Glenn
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 13th, 2007
Last updated Mar 31st, 2021 - about 5 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1780808196 NPPES
Arkansas MEDICAID 135850002

Popular Providers