KENNETH JAKE SAMPLE

GRAVETTE, AR
NPI1699358960
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: AR  E-18299)
Enumeration Date2021-05-04
Last Update Date2024-08-05
Business Address
Dr. KENNETH JAKE SAMPLE MD
1101 JACKSON ST SW
GRAVETTE, AR 72736-9121
Phone number: 479-787-5221
Mailing Address
Dr. KENNETH JAKE SAMPLE MD
1101 JACKSON ST SW
GRAVETTE, AR 72736-9121
Phone number:
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