JTD MD PLLC NPI 1881285187

NPI Information

NPI: 1881285187
Provider Name: JTD MD PLLC
Classification: Ophthalmology - 207WX0107X
Entity Type: Organization

Specialization: Retina Specialist

Address:
1794 E JOYCE BLVD STE 3
FAYETTEVILLE, AR
ZIP 72703
Phone: (479) 234-4499
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JTD MD PLLC is a retina specialist ophthalmology in Fayetteville, AR. The provider is an ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. JTD MD PLLC NPI is 1881285187. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1794 E JOYCE BLVD STE 3
FAYETTEVILLE, AR
ZIP 72703-257
Phone: (479) 234-4499
Fax: (479) 269-1325

The provider's authorized official is Rick Kamerer .
The authorized official title is Administrator and has the following contact phone number (479) 408-4466.

The enumeration date for this NPI number is 1/29/2021 and was last updated on 11/11/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207WX0107X	Ophthalmology	Retina Specialist			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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