Provider Demographics
NPI:1720299647
Name:HARWOOD, JEREMY SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:SCOTT
Last Name:HARWOOD
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 1:4 CATLETT LN
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-2194
Mailing Address - Country:US
Mailing Address - Phone:575-386-9048
Mailing Address - Fax:
Practice Address - Street 1:16221 SAINT VINCENT WAY
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-9072
Practice Address - Country:US
Practice Address - Phone:501-552-8150
Practice Address - Fax:501-552-8199
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-7993208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics