# JTD MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881285187
- **Authorized official:** RICK KAMERER (ADMINISTRATOR)
- **Authorized official phone:** (479) 408-4466

## Contact information

- **Practice address:** 1794 E JOYCE BLVD STE 3, FAYETTEVILLE, AR 72703-5257
- **Practice address phone:** (479) 234-4499
- **Practice address fax:** (479) 269-1325
- **Mailing address:** 1794 E JOYCE BLVD STE 3, FAYETTEVILLE, AR 72703-5257
- **Mailing address phone:** (479) 234-4499
- **Mailing address fax:** (479) 269-1325

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | NULL | Yes |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/29/2021
- **Last updated:** 11/11/2021