Healthcare Provider Details

I. General information

NPI: 1679684336
Provider Name (Legal Business Name): JEFFREY KIRCHNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 SPRINGHILL DR
NORTH LITTLE ROCK AR
72117-2922
US

IV. Provider business mailing address

904 AUTUMN RD
LITTLE ROCK AR
72211-3702
US

V. Phone/Fax

Practice location:
  • Phone: 501-202-6800
  • Fax:
Mailing address:
  • Phone: 501-202-4209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberC6939
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: