Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | E-6711 | AR |
NPI | 1003035338 |
---|---|
Provider Name | Benjamin J. Jumper |
First Address | Sunrise, FL 33345-2035 |
Second Address | El Dorado, AR 71730 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2007 |
Last Update Date | 05/01/2011 |