Kelly, Jennifer Johnson

Kelly, Jennifer Johnson is an individual health care provider with primary practice located at 245 Madison St , Clarendon AR 72029-2706. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Kelly, Jennifer Johnson can be contacted via phone (870) 747-3381.

Contact Information

Primary practice address
245 Madison St Clarendon AR 72029-2706
Phone: (870) 747-3381
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X E6540 Arkansas

Profile Details

NPI number 1649320607
LBN Legal business name Kelly, Jennifer Johnson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2007
Last updated Apr 4th, 2024 - about 2 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 1649320607 NPPES
Arkansas MEDICAID 184379001

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