Individual
JI MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 TOWSON AVE, FT. SMITH, AR 72901
(479) 441-4000
(479) 709-7053
Mailing address
PO BOX 2420, FORT SMITH, AR 72902-2420
(479) 709-7399
(479) 709-7053
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E5328
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166388001
—
AR
05
—
200115950A
—
OK
Enumeration date
07/05/2007
Last updated
05/21/2021
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