Healthcare Provider Details

I. General information

NPI: 1720933369
Provider Name (Legal Business Name): JIMMIE JUSTIN HARPER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 N 26TH ST STE A
ARKADELPHIA AR
71923-4366
US

IV. Provider business mailing address

208 N 26TH ST STE A
ARKADELPHIA AR
71923-4366
US

V. Phone/Fax

Practice location:
  • Phone: 870-246-2583
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: