Individual
MR. JEFFERY LANE ULMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
1102 CRESTWOOD CIR, MENA, AR 71953-5513
(479) 394-7301
(479) 394-7160
Mailing address
1102 CRESTWOOD CIR, MENA, AR 71953-5513
(479) 394-7301
(479) 394-7160
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-116
AR
Other
Enumeration date
06/15/2006
Last updated
12/23/2013
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