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:
Health care specialties
| Specialty | Code | License # | 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 18 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 | 1982696464 | NPPES |
| Arkansas | MEDICAID | 130436716 | |
| Arkansas | Other | 52911 | |
| Arkansas | Other | 12591000000 | |
| Arkansas | Other | 200017919 | |
| Arkansas | MEDICAID | 115941001 |
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