Healthcare Provider Details

I. General information

NPI: 1689171712
Provider Name (Legal Business Name): JACOB H LEFFERT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2018
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 CARTI WAY
LITTLE ROCK AR
72205-6523
US

IV. Provider business mailing address

PO BOX 55050
LITTLE ROCK AR
72215-5050
US

V. Phone/Fax

Practice location:
  • Phone: 501-906-3000
  • Fax: 501-907-8367
Mailing address:
  • Phone: 501-906-3000
  • Fax: 501-907-8367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberE-14327
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: