JOHN CLIFTON FAIRCLOTH (NPI# 1578982526) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578982526 |
| Entity Type | Individual |
| Full Name | JOHN CLIFTON FAIRCLOTH |
| Credential | D.O |
| Practice Address |
800 S Chuch St Suite 101 Jonesboro AR 72401 |
| Mailing Address |
3209 Mallard Pointe Cv Jonesboro AR 72404-7085 |
| Practice Telephone | 8709320639 |
| Mailing Telephone | 5016503667 |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2019-09-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
E12135 | AR | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346742988 | John William Faircloth | Speech-Language Pathologist | 2107 Liberty St, Chesapeake, VA 23324-3527 | 2018-02-28 |
| 1063543890 | John Myron Faircloth | Nurse Practitioner | 127 E Redstone Ave Ste C, Crestview, FL 32539-5356 | 2007-03-07 |
| Street Address |
800 S CHUCH ST SUITE 101 |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
| 1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
| 1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
| 1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
| 1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
| 1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
| 1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
| 1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
| 1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
| 1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
| Find all providers in zip 72401 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083053615 | Caraway Medical Center | Radiology | 2929 S Caraway Rd Ste 1, Jonesboro, AR 72401-7335 | 2013-06-17 |
| 1184984155 | Holly Jo Gonzales | Radiology | 800 S Church St Ste 101, Jonesboro, AR 72401 | 2012-05-23 |
| 1922121698 | Wolf E Heberlein | Radiology | 3800 E Johnson Ave, Ste E, Jonesboro, AR 72401-1931 | 2007-04-09 |
| 1023074002 | Jeff Mullen | Radiology | 3100 Apache Dr, Suite C1, Jonesboro, AR 72401-7404 | 2006-04-26 |
| 1376506980 | St.bernards Imaging Center | Radiology | 1144 E Matthews Ave, Jonesboro, AR 72401-4314 | 2006-04-07 |
| 1518961580 | John Kenneth Phillips | Radiology | 3024 Stadium Blvd, Jonesboro, AR 72401-7415 | 2005-06-08 |
| 1609878867 | Richard R Reinholtz | Radiology | 225 E Jackson Ave, Jonesboro, AR 72401-3119 | 2005-06-01 |
| 1912136524 | Georgia Vascular Institute, LLC | Radiology | 7823 Spivey Station Blvd, Suite 300, Jonesboro, GA 30236-2886 | 2009-07-06 |
| 1679715130 | Ezekiel Elliott Shotts | Radiology | 4800 E Johnson Ave, Jonesboro, AR 72401-8413 | 2009-03-30 |
| 1356516330 | Angela V Frost | Radiology | 4802 E Johnson Ave, Jonesboro, AR 72401-8413 | 2008-04-29 |
| Find all providers in JONESBORO | ||||
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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.