Individual
KENNETH CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4802 E JOHNSON AVE, JONESBORO, AR 72401-8413
(870) 936-8000
(870) 934-3635
Mailing address
PO BOX 1960, JONESBORO, AR 72403-1960
(870) 936-8000
(870) 934-3635
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
E-0805
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129976003
—
AR
Enumeration date
04/13/2006
Last updated
01/04/2016
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