JACKY FRED DUNN (NPI# 1235195306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235195306 |
| Entity Type | Individual |
| Full Name | JACKY FRED DUNN |
| Credential | DO |
| Practice Address |
609 West Clark Street Jasper AR 72641-0130 |
| Mailing Address |
Po Box 1060 Marshall AR 72650-1060 |
| Practice Telephone | 8704462225 |
| Practice Fax Number | 8704462227 |
| Mailing Telephone | 8704485101 |
| Mailing Fax Number | 8704483767 |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2019-01-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | N7589 | AR | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | N-7589 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 109930003 | 05 |
| Street Address |
609 WEST CLARK STREET |
| City | JASPER |
| State | AR |
| Zip Code | 72641-0130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609243674 | Boston Mountain Rural Health Center Inc. | Clinic/Center | 609 West Clark Street, Jasper, AR 72641-0130 | 2015-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467091439 | James Patrick Martin | Massage Therapist | 100 West South Street, Jasper, AR 72641 | 2019-12-23 |
| 1811442577 | Tember Mcneill | Chiropractor | 514 W. Clark Street, Suite 340, Jasper, AR 72641 | 2016-08-23 |
| 1598178493 | North Arkansas Regional Medical Center | Pediatrics | 609 W Clark, Jasper, AR 72641 | 2014-06-09 |
| 1740426287 | Health Resources of Arkansas, Inc. | Community/Behavioral Health | 504 West Court Street, Room 110, Jasper, AR 72641 | 2009-01-06 |
| 1912143280 | Linda Casey Sides | Nurse Practitioner | 502 W Court Street, Jasper, AR 72641 | 2008-12-17 |
| 1831359587 | Mary Dennise Pollyea | Social Worker | 105 Red Oak Lane, Jasper, AR 72641 | 2008-06-16 |
| 1104971373 | Johnny Lee Smith | Nurse Practitioner | 502 West Court, Jasper, AR 72641 | 2007-01-25 |
| 1720064223 | Jennifer Shepherd | Nurse Practitioner | 502 West Court Street., Jasper, AR 72641 | 2005-12-16 |
| 1780674143 | James B Justice | Family Medicine | 502 W Court, Jasper, AR 72641 | 2005-10-26 |
| 1588654982 | North Arkansas Regional Medical Center | Clinic/Center | 502 W Court St, Jasper, AR 72641 | 2005-10-26 |
| Find all providers in zip 72641 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1043312101 | Bill Yates | General Practice | 203 19th Street East, Jasper, AL 35501 | 2006-09-01 |
| 1952642092 | Joseph Thomas Williams Jr. | General Practice | 6610 Curry Hwy, Jasper, AL 35503-5664 | 2013-03-14 |
| 1013115294 | Bhc-medstat of Jasper | General Practice | 3400 Highway 78 E, Medical Arts Tower; Suite 109, Jasper, AL 35501-8907 | 2007-07-10 |
| 1285769463 | Grandview Physician Group LLC | General Practice | 980 Highway 28, Suite 102, Jasper, TN 37347-3695 | 2007-02-21 |
| 1184719155 | Medical of Dubois A Professional Corporation | General Practice | 695 3rd Ave, Jasper, IN 47546-3602 | 2006-10-04 |
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| 1083269690 | University of Arkansas At Monticello | General Practice | 663 University Drive, Monticello, AR 71656 | 2019-08-09 |
| 1912492786 | Chelsea Brown | General Practice | 6309 Highway 5 N, Bryant, AR 72022-8506 | 2018-06-25 |
| 1205345154 | Lakeside Walk-in Clinic Pllc | General Practice | 2230 Malvern Ave Ste E, Hot Springs, AR 71901-8000 | 2017-09-22 |
| 1558897595 | Epoch-nwa Pllc | General Practice | 5100 W Pauline Whitaker Pkwy, Ste. 110, Rogers, AR 72758-8335 | 2017-05-11 |
| 1023540655 | Aaron M Smith | General Practice | Varner Unit State Hwy 388, Gould, AR 71643 | 2017-04-02 |
| 1942749148 | Reece Lewis Crow | General Practice | 34 Windsor Road, Little Rock, AR 72212 | 2017-02-21 |
| Find all providers with the same taxonomy | ||||
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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.