Provider Demographics
NPI:1740374818
Name:RESIMONT, JEFF FRANK (DPM)
Entity type:Individual
Prefix:
First Name:JEFF
Middle Name:FRANK
Last Name:RESIMONT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 W SEVIER ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72830-3627
Mailing Address - Country:US
Mailing Address - Phone:479-754-2811
Mailing Address - Fax:479-754-2984
Practice Address - Street 1:203 W SEVIER ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-3627
Practice Address - Country:US
Practice Address - Phone:479-754-2811
Practice Address - Fax:479-754-2984
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR130213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5S493Medicare ID - Type Unspecified
ARU41049Medicare UPIN