DR. JIMMY DAVID ACKLIN M.D. NPI 1356345052

NPI Information

NPI: 1356345052
Provider Name: DR. JIMMY DAVID ACKLIN, M.D.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Organization: RIVER VALLEY PRIMARY CARE SERVICES

PECOS Registration: Yes

Address:
612 S 12TH ST
FORT SMITH, AR
ZIP 72901
Phone: (479) 785-2431
Get Directions

DR. Jimmy David Acklin, M.D. is a family medicine in Fort Smith, AR with 41 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Jimmy David Acklin, M.D. NPI is 1356345052. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
Graduation Year:1983

The provider's business location address is:

612 S 12TH ST
FORT SMITH, AR
ZIP 72901-702
Phone: (479) 785-2431
Fax: (479) 494-7787

The NPI 1356345052 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/9/2005 and was last updated on 3/18/2021.

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	207Q00000X	Family Medicine		C-6363	ARKANSAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	077391301	OTHER	TEXAS	MEDICAID
2	6019495001	OTHER		CIGNA
3	913056000	OTHER	FLORIDA	MEDICAID
4	080072068	OTHER	ARKANSAS	RAILROAD MEDICARE
5	13803000000	OTHER	ARKANSAS	QUALCHOICE
6	4627033	OTHER		AETNA
7	100071990A	MEDICAID	OKLAHOMA
8	100267820A	OTHER	KANSAS	MEDICAID
9	110763001	MEDICAID	ARKANSAS
10	1632163	MEDICAID	LOUISIANA
11	1899432	OTHER	ARKANSAS	UNITED HEALTHCARE
12	05508082	MEDICAID	MISSISSIPPI
13	50026	OTHER	ARKANSAS	BLUE CROSS/BLUE SHIELD
14	AA2063650	OTHER	ARKANSAS	DEA NUMBER

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: 11/14/2023

NPI Synchronization or Removal

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