Healthcare Provider Details

I. General information

NPI: 1811892987
Provider Name (Legal Business Name): CHRISTOPHER LEE MCMUNN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 S WALDRON RD
FORT SMITH AR
72903-2556
US

IV. Provider business mailing address

1607 STONE ST
JONESBORO AR
72401-5332
US

V. Phone/Fax

Practice location:
  • Phone: 479-755-6601
  • Fax:
Mailing address:
  • Phone: 870-336-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: