DR. JACK L MAGNESS JR. (NPI# 1598782294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598782294 |
| Entity Type | Individual |
| Full Name | DR. JACK L MAGNESS JR. |
| Credential | MD |
| Practice Address |
6801 Rogers Ave Fort Smith AR 72903-4067 |
| Mailing Address |
Po Box 3528 Fort Smith AR 72913-3528 |
| Practice Telephone | 4792742000 |
| Practice Fax Number | 4792742194 |
| Mailing Telephone | 4792742000 |
| Mailing Fax Number | 4792742194 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2015-08-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | C-3363 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 105622001 | 05 | |
| RR MEDICARE | 070002980 | 01 |
| Street Address |
6801 ROGERS AVE |
| City | FORT SMITH |
| State | AR |
| Zip Code | 72903-4067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649277401 | Frederick B Niegos | Internal Medicine | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2005-07-07 |
| 1760949887 | Rachel Elise Jones | Nurse Practitioner | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2019-02-25 |
| 1720592223 | Mercy Clinic Fort Smith Communities | Durable Medical Equipment & Medical Supplies | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2017-11-21 |
| 1588117519 | Cooper Clinic Pa | Physical Therapist | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2016-07-26 |
| 1427501451 | Yong Ounpraseuth | Nurse Practitioner | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2016-07-26 |
| 1386011211 | Cooper Clinic, Pa | Physical Therapist | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2015-08-26 |
| 1518333988 | Gary Widner | Physical Therapist | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2015-08-19 |
| 1699151209 | Jason Johnson | Audiologist | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2015-08-05 |
| 1316336761 | Cooper Clinic, Pa | Pharmacist | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2015-01-22 |
| 1386042927 | Mandy Lee Fluitt | Nurse Practitioner | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2014-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285280016 | Bhg L, LLC | Clinic/Center | 1501 Waldron Road, Ste 203, Fort Smith, AR 72903 | 2019-08-16 |
| 1457905903 | Heather Snyder | Optometrist | 1021 South Waldron Road, Fort Smith, AR 72903 | 2019-08-01 |
| 1083272223 | Pediatric Therapy Connections LLC | Clinic/Center | 7601 Westminister Pl, Fort Smith, AR 72903 | 2019-06-03 |
| 1073092821 | Baptist Health Services | Psychiatry & Neurology | 3808 Gary St Ste B, Fort Smith, AR 72903 | 2018-08-13 |
| 1104305853 | Baptist Health Services | Family Medicine | 5428 Ellsworth Rd Ste A, Fort Smith, AR 72903 | 2018-08-13 |
| 1417436171 | Baptist Health Services | Pediatrics | 5428 Ellsworth Rd Ste B, Fort Smith, AR 72903 | 2018-08-13 |
| 1558840421 | Baptist Health Services | Family Medicine | 3808 Gary St Ste A, Fort Smith, AR 72903 | 2018-08-10 |
| 1316434707 | Md Weight Loss and Wellness, LLC | Dietitian, Registered | 3416 Old Greenwood Road, Fort Smith, AR 72903 | 2018-04-20 |
| 1942695572 | Donna K Morgan | Counselor | 2408 S. 51st Court Suite G, Fort Smith, AR 72903 | 2015-03-31 |
| 1346658242 | Shelby Mural Esry | Dentist | 3200 Rogers Ave. Suite 111, Fort Smith, AR 72903 | 2014-07-24 |
| Find all providers in zip 72903 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538165295 | Brad Russell Johnson | Dermatology | 9207 Highway 71 S, Suite 9, Fort Smith, AR 72916-9117 | 2005-06-27 |
| 1255788352 | Chelsea Jones Meltzer | Dermatology | 5921 Riley Park Dr, Fort Smith, AR 72916-6103 | 2016-05-18 |
| 1376780098 | The Dermatology Center Pllc | Dermatology | 1500 Dodson Ave, Suite 270, Fort Smith, AR 72901-5182 | 2009-01-16 |
| 1649450172 | Nedil Aldarondo-antonini | Dermatology | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2007-11-13 |
| 1417978958 | George Luke Lewis | Dermatology | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2006-07-21 |
| 1013904176 | Cyril E Severns | Dermatology | 1500 Dodson Ave, Ste 270, Fort Smith, AR 72901-5182 | 2005-10-04 |
| 1821085887 | Phillip C Stites | Dermatology | 1500 Dodson Ave, Ste 270, Fort Smith, AR 72901-5182 | 2005-10-04 |
| 1447256102 | Sandra Marchese Johnson | Dermatology | 1301 S E St, Fort Smith, AR 72901-4716 | 2005-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677737 | Prime Medical Group Pllc | Dermatology | 1416 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2020-10-20 |
| 1790384808 | Prime Medical Group Pllc | Dermatology | 625 United Dr Ste 320, Conway, AR 72032-7828 | 2020-10-20 |
| 1649879750 | Prime Medical Group Pllc | Dermatology | 5 Medical Park Dr Ste 200, Benton, AR 72015-3732 | 2020-10-20 |
| 1528667672 | Prime Medical Group Pllc | Dermatology | 315 Section Line Rd Ste A&b, Hot Springs, AR 71913-6480 | 2020-10-20 |
| 1487064473 | Laura Raquel Battle | Dermatology | 500 South 52nd Street, Rogers, AR 72758-7275 | 2014-04-30 |
| 1174942528 | Jacey Tanner Guthrie | Dermatology | 4200 N Rodney Parham Rd Ste 202, Little Rock, AR 72212 | 2014-04-14 |
| 1801215751 | Allison Noel Hood | Dermatology | 9601 Baptist Health Drive Suite 860, Little Rock, AR 72205 | 2014-04-08 |
| 1710229141 | Mallory Hurst | Dermatology | 800 S Church St Ste 202, Jonesboro, AR 72401 | 2013-03-24 |
| 1720333990 | Vivian Shi | Dermatology | 4018 W Capitol Ave, Little Rock, AR 72205 | 2012-07-13 |
| 1295098440 | Garrett James Nelson | Dermatology | 9601 Baptist Health Dr Ste 690, Little Rock, AR 72205-6328 | 2012-06-22 |
| Find all providers with the same taxonomy | ||||
| City | FORT SMITH |
| Zip Code | 72903 |
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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.