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Individual

JEFFREY JOHN CARFAGNO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1900 CLUB MANOR DR STE 105, MAUMELLE, AR 72113-7443
(501) 851-8100
(501) 851-4712
Mailing address
1900 CLUB MANOR DR STE 105, MAUMELLE, AR 72113-7443
(501) 851-8100
(501) 851-4712

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C6805
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080037331
RR MEDICARE
01
11200000040
QUALCHOICE
05
116678001
AR
01
1670460
UNITED HEALTHCARE
AR
01
51945
BLUE CROSS BLUE SHIELD
AR
Enumeration date
09/06/2006
Last updated
12/17/2009
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