MEDICARE: DR. KYLE D JARNAGIN D.C.

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
1	111N00000X	Chiropractor	1622	AR

Other Identifiers

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

General Provider Information

NPI Number	:	1487654901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KYLE D JARNAGIN D.C.

Provider Business Mailing Address
First Line	:	3444 OLD GREENWOOD RD
Second Line	:	SUITE A
City	:	FORT SMITH
State	:	AR
Zip	:	72903-5462
Country	:	US
Telephone Number	:	497-646-3984
Fax Number	:	479-646-2129

Provider Business Practice Location Address
First Line	:	3444 OLD GREENWOOD RD
Second Line	:	SUITE A
City	:	FORT SMITH
State	:	AR
Zip	:	72903-5462
Country	:	US
Telephone Number	:	497-646-3984
Fax Number	:	479-646-2129

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2005
Last Update Date	:	01/06/2021

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