Luttrell, Rex E

Luttrell, Rex E is an sole proprietor health care provider with primary practice located at 1300 Braden St Pod B, Jacksonville AR 72076-3719. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Luttrell, Rex E can be contacted via phone (501) 978-4343.

Contact Information

Primary practice address
1300 Braden St Pod B Jacksonville AR 72076-3719
Phone: (501) 978-4343
Fax: (501) 975-8995
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X C-6721 Arkansas

Profile Details

NPI number 1477559680
LBN Legal business name Luttrell, Rex E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 22nd, 2005
Last updated Oct 25th, 2012 - about 12 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 1477559680 NPPES
Arkansas MEDICAID 123268001
Arkansas Other 16173000000
Arkansas Other 17-20039
Arkansas Other P01071366
Arkansas Other P00004959

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