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NPI Code Detail

MEDICARE: JAMES KIRKENDOLL RECOVERY ASSISTANT

MEDICARE: JAMES KIRKENDOLL RECOVERY ASSISTANT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care CoordinatorAR

General Provider Information

NPI Number : 1750527057
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES KIRKENDOLL RECOVERY ASSISTANT
Provider Business Mailing Address
First Line : 110 PEARSON
Second Line :
City : BENTON
State : AR
Zip : 72015-4436
Country : US
Telephone Number : 501-315-4424
Fax Number : 501-778-0450
Provider Business Practice Location Address
First Line : 310 WHITTINGTON AVE
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71901-3406
Country : US
Telephone Number : 501-623-3477
Fax Number : 501-624-7498
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2008
Last Update Date : 02/26/2025

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