Healthcare Provider Details

I. General information

NPI: 1497947550
Provider Name (Legal Business Name): JENNIFER ASHLEY MCLAUGHLIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER ASHLEY BROOKS

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 08/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 HOSPITAL CIRCLE SUITE B
BATESVILLE AR
72501
US

IV. Provider business mailing address

16 HOSPITAL CIRCLE SUITE B
BATESVILLE AR
72501
US

V. Phone/Fax

Practice location:
  • Phone: 870-793-7800
  • Fax: 870-793-7801
Mailing address:
  • Phone: 870-793-7800
  • Fax: 870-793-7801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberE-6447
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: