Provider Demographics
NPI:1790855534
Name:JONES, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:JONES
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 1:9501 LILE DR STE 600
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6231
Mailing Address - Country:US
Mailing Address - Phone:501-227-7596
Mailing Address - Fax:501-227-7787
Practice Address - Street 1:9501 LILE DR STE 600
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6231
Practice Address - Country:US
Practice Address - Phone:501-227-7596
Practice Address - Fax:501-227-7787
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116017314207R00000X
ARE-5870207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR178612001Medicaid
AR5H825Medicare PIN