Individual
DR. JAY DANIEL GEOGHAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3343 SPRINGHILL DR, SUITE 1035, NORTH LITTLE ROCK, AR 72117-2929
(501) 975-7676
(501) 537-0206
Mailing address
3343 SPRINGHILL DR, STE 1035, NORTH LITTLE ROCK, AR 72117-2929
(501) 975-7676
(501) 537-0206
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
E-2040
AR
207RC0000X
Cardiovascular Disease Physician
ME88853
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5N795
BLUE CROSS BLUE SHIELD
AR
01
—
CC6745
RAILROAD MEDICARE
AR
01
—
CN1884
RAILROAD MEDICARE
AR
Enumeration date
09/08/2005
Last updated
10/04/2011
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