Provider Demographics
NPI:1003025594
Name:IRELAND, JAMIE D (MD)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:D
Last Name:IRELAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:D
Other - Last Name:IRELAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1983
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72902-1983
Mailing Address - Country:US
Mailing Address - Phone:479-452-9416
Mailing Address - Fax:479-242-1990
Practice Address - Street 1:4300 WEST 7TH STREET
Practice Address - Street 2:JOHN L. MCCLELLAN MEMORIAL VETERANS HOSPITAL
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-257-6615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR73332085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging