Provider Demographics
NPI:1346276441
Name:MENARD, JOHN C (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:MENARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3612 COMMONWEALTH DR
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-7053
Mailing Address - Country:US
Mailing Address - Phone:501-940-0070
Mailing Address - Fax:501-377-9195
Practice Address - Street 1:3612 COMMONWEALTH DR
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-7053
Practice Address - Country:US
Practice Address - Phone:501-940-0070
Practice Address - Fax:501-377-9195
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC8134207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR55535OtherBCBS
AR121554001Medicaid
AR55535OtherBCBS
ARF27255Medicare UPIN