Healthcare Provider Details

I. General information

NPI: 1386482495
Provider Name (Legal Business Name): PTMD CONSULTANTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2024
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 OFFICE PARK DR STE 3
BRYANT AR
72022-7536
US

IV. Provider business mailing address

408 OFFICE PARK DR STE 3
BRYANT AR
72022-7536
US

V. Phone/Fax

Practice location:
  • Phone: 501-553-0000
  • Fax: 501-232-7969
Mailing address:
  • Phone: 501-553-0000
  • Fax: 501-232-7969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SAMEER JAIN
Title or Position: PHYSICIAN
Credential: MD
Phone: 501-553-0000