Healthcare Provider Details

I. General information

NPI: 1144293630
Provider Name (Legal Business Name): JASON H PLEIMANN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3317 N WIMBERLY DR
FAYETTEVILLE AR
72703-4056
US

IV. Provider business mailing address

PO BOX 1608
FAYETTEVILLE AR
72702-1608
US

V. Phone/Fax

Practice location:
  • Phone: 479-521-2752
  • Fax: 479-443-7862
Mailing address:
  • Phone: 479-521-2752
  • Fax: 479-443-7862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberE3242
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License NumberE3242
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: