Provider Demographics
NPI:1639457708
Name:JAMESON, JONATHAN DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:DAVID
Last Name:JAMESON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:5507 RANCH DR
Mailing Address - Street 2:STE 3
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-4538
Mailing Address - Country:US
Mailing Address - Phone:501-673-3110
Mailing Address - Fax:501-673-3159
Practice Address - Street 1:123 AUDUBON DR
Practice Address - Street 2:STE. #700
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-5500
Practice Address - Country:US
Practice Address - Phone:501-851-6685
Practice Address - Fax:501-851-6495
Is Sole Proprietor?:No
Enumeration Date:2011-07-23
Last Update Date:2017-01-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AR15751111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor