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General NPI Number Information
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NPI Number | 1881708154
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Entity Type | Individual
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Provider Name | JAY ROBERT MARKS MD
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2 SAINT VINCENT'S CIRCLE
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City | LITTLE ROCK
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State | AR
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Zip | 72205
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Country | US
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Telephone | 501-522-2678
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Fax |
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Provider Business Mailing Address
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Address Line | 1611 WETHERBORNE DRIVE
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City | LITTLE ROCK
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State | AR
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Zip | 72211
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Country | US
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Telephone | 501-258-9726
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | N-6093
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License Number State | AR
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