Ennis, Jared

Ennis, Jared is an individual health care provider with primary practice located at 4019 N Remington Dr , Fayetteville AR 72703-6344. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Ennis, Jared can be contacted via phone (479) 595-8192.

Contact Information

Primary practice address
4019 N Remington Dr Fayetteville AR 72703-6344
Phone: (479) 595-8192
Fax: (479) 442-1748
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X E-4271 Arkansas
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X E-4271 Arkansas

Profile Details

NPI number 1467539155
LBN Legal business name Ennis, Jared
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Mar 29th, 2023 - about 3 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 1467539155 NPPES
Arkansas MEDICAID 157891001

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