Provider Demographics
NPI:1619173150
Name:CASEY, JENNIFER DUKES (MD)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:DUKES
Last Name:CASEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1401 W CAPITOL AVE
Mailing Address - Street 2:PLAZA E
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72201-2936
Mailing Address - Country:US
Mailing Address - Phone:501-320-7000
Mailing Address - Fax:501-320-7001
Practice Address - Street 1:1401 W CAPITOL AVE
Practice Address - Street 2:PLAZA E
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-2936
Practice Address - Country:US
Practice Address - Phone:501-320-7000
Practice Address - Fax:501-320-7001
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ARE-5856207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program