Phillips, John Kenneth

Phillips, John Kenneth is an individual health care provider with primary practice located at 3024 Stadium Blvd , Jonesboro AR 72401-7415. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Phillips, John Kenneth can be contacted via phone (870) 934-5113.

Contact Information

Primary practice address
3024 Stadium Blvd Jonesboro AR 72401-7415
Phone: (870) 934-5113
Fax: (870) 392-3608
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X E0129 Arkansas

Profile Details

NPI number 1518961580
LBN Legal business name Phillips, John Kenneth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2005
Last updated Dec 1st, 2016 - about 8 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 1518961580 NPPES
Missouri MEDICAID 208891804
Missouri MEDICAID 129236001

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