Provider Demographics
NPI:1417913484
Name:GARNER, JULEA (MD)
Entity Type:Individual
Prefix:DR
First Name:JULEA
Middle Name:
Last Name:GARNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1995 HWY 62/412
Mailing Address - Street 2:
Mailing Address - City:HARDY
Mailing Address - State:AR
Mailing Address - Zip Code:72542-9262
Mailing Address - Country:US
Mailing Address - Phone:870-856-5620
Mailing Address - Fax:870-856-5623
Practice Address - Street 1:1995 HWY 62/412
Practice Address - Street 2:
Practice Address - City:HARDY
Practice Address - State:AR
Practice Address - Zip Code:72542-9262
Practice Address - Country:US
Practice Address - Phone:870-856-5620
Practice Address - Fax:870-856-5623
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC7695207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR124592001Medicaid
ARF39509Medicare UPIN
AR559000Medicare ID - Type Unspecified