Individual
JONI L. CARMACK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
EAST MAIN & SOUTH 20TH STREET, VAN BUREN, AR 72957
(479) 474-3401
(479) 471-4388
Mailing address
1004 E BRYAN AVE, SAPULPA, OK 74066-4513
(918) 748-7557
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
E-3151
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146400001
—
AR
01
—
5M145
BLUECROSS BLUESHIELD
AR
Enumeration date
01/11/2006
Last updated
12/07/2017
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