Individual
DR. JEFFREY A. MEDLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
937 HIGHWAY 64 EAST, ALMA, AR 72921
(479) 632-3855
(479) 632-0296
Mailing address
937 HIGHWAY 64 EAST, ALMA, AR 72921
(479) 632-3855
(479) 632-0296
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-0205
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080179030
RR MEDICARE
—
05
—
129661001
—
AR
Enumeration date
07/18/2006
Last updated
11/22/2016
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