Provider Demographics
NPI:1740693183
Name:RENFROE, JAMES A III (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:RENFROE
Suffix:III
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 1:1507 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MCGEHEE
Mailing Address - State:AR
Mailing Address - Zip Code:71654
Mailing Address - Country:US
Mailing Address - Phone:870-222-6131
Mailing Address - Fax:870-222-5909
Practice Address - Street 1:1507 S 1ST ST
Practice Address - Street 2:
Practice Address - City:MCGEHEE
Practice Address - State:AR
Practice Address - Zip Code:71654
Practice Address - Country:US
Practice Address - Phone:870-222-6131
Practice Address - Fax:870-222-5909
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-9527207P00000X
ARE9527207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine