Provider Demographics
NPI:1780675637
Name:LIM, JAYTON A (MD)
Entity type:Individual
Prefix:
First Name:JAYTON
Middle Name:A
Last Name:LIM
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 1:1 EDGEHILL RD
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-9488
Mailing Address - Country:US
Mailing Address - Phone:501-593-5101
Mailing Address - Fax:
Practice Address - Street 1:114 WATER OAK DR
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4551
Practice Address - Country:US
Practice Address - Phone:501-230-6643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-0461207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR127889001Medicaid
G14225Medicare UPIN
ARP00354486Medicare PIN
AR5J872Medicare PIN