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General NPI Number Information
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NPI Number | 1871113720
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Entity Type | Organization
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Legal Business Name | J & R CONSULTING SERVICES PLLC
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Dates
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Enumeration Date | 04/21/2020
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Last Update Date | 05/11/2020
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Provider Practice Location Address
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Address Line | 34 US HIGHWAY 68 E UNIT A
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City | BENTON
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State | KY
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Zip | 42025-8336
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Country | US
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Telephone | 270-410-1195
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 766
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City | BENTON
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State | KY
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Zip | 42025-0766
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Country | US
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Telephone | 270-410-1195
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAMES WISEMAN
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Credential |
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Telephone | 270-410-1195
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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 |
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License Number State |
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