Healthcare Provider Details

I. General information

NPI: 1205001799
Provider Name (Legal Business Name): DAVID VANCE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E OAK AVE
JONESBORO AR
72401-4163
US

IV. Provider business mailing address

201 E OAK AVE
JONESBORO AR
72401-4163
US

V. Phone/Fax

Practice location:
  • Phone: 870-935-6729
  • Fax: 870-268-4478
Mailing address:
  • Phone: 870-935-6729
  • Fax: 870-268-4478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberE9140
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: