Individual
JENNIFER M CO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10001 LILE DR, LITTLE ROCK, AR 72205-6217
(501) 227-8000
(501) 320-1620
Mailing address
10001 LILE DR, LITTLE ROCK, AR 72205-6217
(501) 227-8000
(501) 320-1620
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E-3103
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145364001
—
AR
01
—
686397
MEDICARE ID# FOR CHI ST. VINCENT LITTLE ROCK DIAGNOSTIC CLINIC
AR
Enumeration date
01/10/2007
Last updated
04/17/2019
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