Provider Demographics
NPI:1073621249
Name:ALMOND, JIMMY CLAY (MD)
Entity Type:Individual
Prefix:
First Name:JIMMY
Middle Name:CLAY
Last Name:ALMOND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JIM
Other - Middle Name:
Other - Last Name:ALMOND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:139 BLACKBERRY LN
Mailing Address - Street 2:
Mailing Address - City:LAKEVIEW
Mailing Address - State:AR
Mailing Address - Zip Code:72642-7157
Mailing Address - Country:US
Mailing Address - Phone:407-238-2000
Mailing Address - Fax:
Practice Address - Street 1:139 BLACKBERRY LN
Practice Address - Street 2:
Practice Address - City:LAKEVIEW
Practice Address - State:AR
Practice Address - Zip Code:72642-7157
Practice Address - Country:US
Practice Address - Phone:407-238-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69396207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL42246Medicare ID - Type Unspecified
G62118Medicare UPIN