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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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