Individual
JERRY S DORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
724 DEAVER ST, SPRINGDALE, AR 72764-5356
(479) 751-3202
(479) 756-2721
Mailing address
724 DEAVER ST, SPRINGDALE, AR 72764-5356
(479) 751-3202
(479) 756-2721
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
F2067
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106239001
—
AR
Enumeration date
08/09/2006
Last updated
08/10/2010
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