Individual
DR. JACK HAVDALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 E OAK AVE, JONESBORO, AR 72401
(870) 935-6729
(870) 268-4408
Mailing address
201 E OAK AVE, JONESBORO, AR 72401
(870) 935-6729
(870) 268-4408
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
E3961
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32638100
—
AR
01
—
E3961
STATE LICENSE
AR
Enumeration date
06/20/2005
Last updated
03/07/2023
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