Aniefiok Jacob
Individual provider Active NPI Driver · Jonesboro, AR
NPI 1154955797 · NPPES record last updated Feb 22, 2020
Key facts
- NPI
- 1154955797
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 3306 Shelby Dr
Jonesboro, AR 72404-0637 - Phone
- (870) 219-1692
- NPI assigned
- Feb 22, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver |
172A00000X | Yes |
Addresses
Primary practice location
3306 Shelby Dr
Jonesboro, AR 72404-0637
Mailing address
604 Fox Run Dr
Jonesboro, AR 72404-0511
Phone (870) 623-4013
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | jonesborotransportation45@yahoo.com |
Other providers in Jonesboro, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.