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General NPI Number Information
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NPI Number | 1063499150
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Entity Type | Individual
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Provider Name | JOE C CUMMINS MD
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Gender | Male
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 07/14/2010
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Provider Practice Location Address
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Address Line | 2425 DAVE WARD DR SUITE 401
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City | CONWAY
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State | AR
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Zip | 72034-8686
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Country | US
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Telephone | 501-329-3824
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Fax | 501-327-2957
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Provider Business Mailing Address
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Address Line | 2425 DAVE WARD DR SUITE 401
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City | CONWAY
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State | AR
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Zip | 72034-8686
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Country | US
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Telephone | 501-329-3824
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Fax | 501-327-2957
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C6816
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License Number State | AR
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