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Individual
DR. JIMMY DAVID ACKLIN
Active
Individual
DR. JIMMY DAVID ACKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C-6363
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05508082
—
MS
01
—
077391301
MEDICAID
TX
01
—
080072068
RAILROAD MEDICARE
AR
05
—
100071990A
—
OK
01
—
100267820A
MEDICAID
KS
05
—
110763001
—
AR
01
—
13803000000
QUALCHOICE
AR
05
—
1632163
—
LA
01
—
1899432
UNITED HEALTHCARE
AR
01
—
4627033
AETNA
—
01
—
50026
BLUE CROSS/BLUE SHIELD
AR
01
—
6019495001
CIGNA
—
01
—
913056000
MEDICAID
FL
Enumeration date
06/09/2005
Last updated
03/07/2023
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