Healthcare Provider Details

I. General information

NPI: 1942481155
Provider Name (Legal Business Name): J.B. SOLOMON, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 11/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 LEXINGTON AVE
FORT SMITH AR
72901-5136
US

IV. Provider business mailing address

1100 LEXINGTON AVE
FORT SMITH AR
72901-5136
US

V. Phone/Fax

Practice location:
  • Phone: 479-782-5858
  • Fax: 479-782-5873
Mailing address:
  • Phone: 479-782-5858
  • Fax: 479-782-5873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number556
License Number StateAR

VIII. Authorized Official

Name: MRS. JEAN M. SOLOMON
Title or Position: OWNER
Credential:
Phone: 479-782-5858