DR. DENNIS W JACKS (NPI# 1013909316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013909316 |
| Entity Type | Individual |
| Full Name | DR. DENNIS W JACKS |
| Credential | M.D. |
| Practice Address |
1609 W 40th Ave Ste 301 Pine Bluff AR 71603-6329 |
| Practice Telephone | 8705365162 |
| Practice Fax Number | 8705365198 |
| Mailing Telephone | 8705365162 |
| Mailing Fax Number | 8705365198 |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2016-11-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | C5724 | AR | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063790079 | Dennis William Jacks | Registered Nurse | 6119 Midtown Ave, Suite 201, Little Rock, AR 72205-5313 | 2011-07-25 |
| Street Address |
1609 W 40TH AVE STE 301 |
| City | PINE BLUFF |
| State | AR |
| Zip Code | 71603-6329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407852734 | Amy Boast Cahill | Obstetrics & Gynecology | 1609 W 40th Ave, Ste 204, Pine Bluff, AR 71603-6367 | 2005-06-22 |
| 1851787089 | Katie Loetscher | Nurse Practitioner | 1609 W 40th Ave, #204, Pine Bluff, AR 71603-6319 | 2015-04-14 |
| 1578906152 | Torrance A Walker Md Pa | Preferred Provider Organization | 1609 W 40th Ave, Suite 201, Pine Bluff, AR 71603-6319 | 2013-04-12 |
| 1982940433 | Jefferson Hospital Assn, Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1609 W 40th Ave, Suite 403, Pine Bluff, AR 71603-6319 | 2013-01-02 |
| 1962753574 | Jefferson Hospital Assn, Inc. | Surgery | 1609 W 40th Ave, Suite 403, Pine Bluff, AR 71603-6319 | 2012-09-21 |
| 1275841306 | Jefferson Hospital Association, Inc. | Orthopaedic Surgery | 1609 W 40th Ave, Suite 501, Pine Bluff, AR 71603-6319 | 2010-09-23 |
| 1285865865 | Lisa A Bearden Md Pa | Clinic/Center | 1609 W 40th Ave, Suite 204, Pine Bluff, AR 71603-6319 | 2009-07-30 |
| 1316184815 | Charles A. Clark, Md, Pa | Orthopaedic Surgery | 1609 W 40th Ave, Suite 501, Pine Bluff, AR 71603-6319 | 2009-01-21 |
| 1770750176 | Roy Louis Burrell | Orthopaedic Surgery | 1609 W 40th Ave, Suite 501, Pine Bluff, AR 71603-6319 | 2008-05-14 |
| 1891975173 | Amy Boast Cahill, M.d., P.a. | Clinic/Center | 1609 W 40th Ave, Suite 204, Pine Bluff, AR 71603-6319 | 2007-11-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700445038 | Hannah Carter | Dentist | 3801 S Olive St, Pine Bluff, AR 71603 | 2019-06-11 |
| 1821544628 | Nauman Yunus Md Pa | Internal Medicine | 1600 West 40th Ave, Jefferson Regional Medical Center, Pine Bluff, AR 71603 | 2016-08-31 |
| 1407278120 | Arkansas Cancer Clinic Pa | Radiology | 7200 South Hazel Street, Pine Bluff, AR 71603 | 2014-01-15 |
| 1730515396 | Sharon Yvette Webb | Student in an Organized Health Care Education/Training Program | 2318 Kyle Street, Pine Bluff, AR 71603 | 2013-09-16 |
| 1477992733 | David Larry Byrd | Pharmacist | 5 Longmeadow, Pine Bluff, AR 71603 | 2013-06-20 |
| 1437400371 | Thomas Jordan Harper | Pharmacist | 2809 South Camden Road, Pine Bluff, AR 71603 | 2012-10-01 |
| 1992080469 | C&d Disability.inc | Early Intervention Provider Agency | 4806 W 9th Street, Pine Bluff, AR 71603 | 2011-10-17 |
| 1457645863 | Clifton G Roaf & Marvin Q Caudle | Dentist | 1310 South Linden Street, Pine Bluff, AR 71603 | 2011-06-02 |
| 1932402682 | Mary Campbell | Licensed Practical Nurse | 2302 W. 28th, Suite A, Pine Bluff, AR 71603 | 2010-12-17 |
| 1245468925 | Evan N Newbolt | Ophthalmology | 3805 West 28th Ave, Pine Bluff, AR 71603 | 2009-07-01 |
| Find all providers in zip 71603 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982838488 | Robert Teryl Brooks Jr. | Urology | 4611 Stevens Dr, Pine Bluff, AR 71603-7303 | 2009-05-12 |
| 1093735110 | David Jacks | Urology | 4303 S Mulberry St, Pine Bluff, AR 71603-7017 | 2006-07-20 |
| 1245222553 | David A Lupo | Urology | 1609 W 40th Ave, Ste 301, Pine Bluff, AR 71603-6329 | 2005-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295259406 | Bruno Lopes Cancado Machado | Urology | 4301 W Markham St Ste 540, Little Rock, AR 72205-7101 | 2017-07-29 |
| 1093242000 | Baxter County Regional Hospital Inc | Urology | 628 Hospital Dr Ste 2b, Mountain Home, AR 72653-2953 | 2017-05-22 |
| 1730575432 | Renee Powell Warford | Urology | 1 Mercy Ln Ste 200a, Hot Springs, AR 71913-6457 | 2015-04-09 |
| 1215370861 | Nathan R Littlejohn | Urology | 1662 Higdon Ferry Rd Ste 140, Hot Springs, AR 71913 | 2013-04-14 |
| 1366739971 | Gerald Mark Heulitt | Urology | 4200 Stockton Dr, North Little Rock, AR 72117-2915 | 2011-07-03 |
| 1487972527 | Rudolph Noah Bowens Jr. | Urology | 303 E Matthews Ave Ste 100, Jonesboro, AR 72401-3113 | 2010-05-13 |
| 1255578894 | Alina Mielnick, Md, Pa | Urology | 601 Bd Highway 71 North, Mena, AR 71953-4394 | 2009-01-20 |
| 1225297260 | Diana Kay Braziel | Urology | 3400 Se Macy Road, Suite 18, Bentonville, AR 72712 | 2008-06-05 |
| 1437348745 | Enoch Walden Williams | Urology | 3817 S Culberhouse Rd, Jonesboro, AR 72404-9067 | 2007-10-23 |
| 1801091244 | Robert Guy Lassonde | Urology | 205 Purple Martin Ln, Hot Springs, AR 71913-8599 | 2007-06-17 |
| Find all providers with the same taxonomy | ||||
| City | PINE BLUFF |
| Zip Code | 71603 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.