Tedder, Michael
Tedder, Michael is an individual health care provider with primary practice located at 3003 Apache Dr , Jonesboro AR 72401-7432. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Tedder, Michael can be contacted via phone (870) 931-8800.Contact Information
Primary practice address
3003 Apache Dr
Jonesboro AR 72401-7432
Phone: (870) 931-8800
Fax: (870) 934-3656
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | C-4865 | Arkansas |
Profile Details
| NPI number | 1962463091 |
|---|---|
| LBN Legal business name | Tedder, Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 29th, 2006 |
| Last updated | Mar 23rd, 2016 - about 9 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 | 1962463091 | NPPES |
| Arkansas | MEDICAID | 102541001 |
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