Ghormley, Jonathan T

Ghormley, Jonathan T is an individual health care provider with primary practice located at 550 Club Lane Suite 1, Conway AR 72034-3681. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Ghormley, Jonathan T can be contacted via phone (501) 329-1510.

Contact Information

Primary practice address
550 Club Lane Suite 1 Conway AR 72034-3681
Phone: (501) 329-1510
Fax: (501) 329-5697
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X R3946 Arkansas

Profile Details

NPI number 1982696464
LBN Legal business name Ghormley, Jonathan T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Dec 31st, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982696464 NPPES
Arkansas MEDICAID 130436716
Arkansas Other 52911
Arkansas Other 12591000000
Arkansas Other 200017919
Arkansas MEDICAID 115941001

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