Provider Demographics
NPI:1750397824
Name:LINK, JOEL RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:RICHARD
Last Name:LINK
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:PO BOX 2650
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71613-2650
Mailing Address - Country:US
Mailing Address - Phone:870-541-7211
Mailing Address - Fax:
Practice Address - Street 1:1801 W 40TH AVE STE 1B
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-6956
Practice Address - Country:US
Practice Address - Phone:870-541-6055
Practice Address - Fax:870-541-6056
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-094159207Y00000X
ARE-15148207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000433254OMedicaid
GA000433254QMedicaid
GA52451117-0037OtherBC/BS
OH2998716Medicaid
GA00433254PMedicaid
GA52451117-0037OtherBC/BS
OH2998716Medicaid
GA000433254QMedicaid