Organization
JENNIFER BINGHAM MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BINGHAM M.D. (OWNER/PHYSICIAN)
(479) 351-9476
Entity
Organization
Contact information
Practice address
15785 W HIGHWAY 62 STE 1, PRAIRIE GROVE, AR 72753-9201
(479) 351-9476
(479) 287-4586
Mailing address
15785 W HIGHWAY 62, PRAIRIE GROVE, AR 72753-9201
(479) 351-9476
(479) 287-4586
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135065001
—
AR
Enumeration date
06/26/2012
Last updated
11/13/2020
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