Healthcare Provider Details

I. General information

NPI: 1053132621
Provider Name (Legal Business Name): PTMD CONSULTANTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
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: 501-600-4781
Mailing address:
  • Phone: 501-553-0000
  • Fax: 501-600-4781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: SAMEER JAIN
Title or Position: OWNER OF ENTITY
Credential:
Phone: 856-313-7911