Provider Demographics
NPI:1689477903
Name:DILLARD, ANDREW JARED (DO (MAY 2025))
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JARED
Last Name:DILLARD
Suffix:
Gender:
Credentials:DO (MAY 2025)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 AZURE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72956-2108
Mailing Address - Country:US
Mailing Address - Phone:479-629-3418
Mailing Address - Fax:479-922-2226
Practice Address - Street 1:7003 CHAD COLLEY BLVD
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72923
Practice Address - Country:US
Practice Address - Phone:479-431-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program