Individual
DAVID JACKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4303 S MULBERRY ST, PINE BLUFF, AR 71603-7017
(870) 535-4221
(870) 535-4228
Mailing address
4303 S MULBERRY ST, PINE BLUFF, AR 71603-7017
(870) 535-4221
(870) 535-4228
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
C5066
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10493001
—
AR
Enumeration date
07/20/2006
Last updated
04/05/2022
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