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NPI Code Detail

MEDICARE: DR. JACK JAY STERNBERG M.D.

MEDICARE: DR. JACK JAY STERNBERG M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1173000000XLegal MedicineC5323AR
2174400000XSpecialistC5323AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1C5323OTHERARLICENSE NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336145218
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACK JAY STERNBERG M.D.
Provider Business Mailing Address
First Line : 1000 N UNIVERSITY AVE
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72207-6347
Country : US
Telephone Number : 501-661-0060
Fax Number : 501-661-1233
Provider Business Practice Location Address
First Line : 1000 N UNIVERSITY AVE
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72207-6347
Country : US
Telephone Number : 501-661-0060
Fax Number : 501-661-1233
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2005
Last Update Date : 06/27/2017

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