Active NPI
Jack Dowell Pittman Jr., DPH. GCP
- Geriatric Pharmacist
- Clinton, AR
National Provider Identifier
1174940894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Pharmacist
- License
- 9700
- Practice address
- 4134 Highway 336 W
Clinton, AR 72031-8311 - Phone
- (501) 745-8784
- NPI assigned
- Mar 19, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Pharmacist | 1835G0303X | 9700 | OK | Primary |
Addresses
Primary practice location
4134 Highway 336 W
Clinton, AR 72031-8311
Mailing address
3 Sergio LN
Hot Springs Village, AR 71909-7929
Phone (501) 472-2550
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9700 | OK | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395187200000",
"number": "1174940894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 SERGIO LN",
"city": "HOT SPRINGS VILLAGE",
"state": "AR",
"postal_code": "719097929",
"telephone_number": "501-472-2550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4134 HIGHWAY 336 W",
"city": "CLINTON",
"state": "AR",
"postal_code": "720318311",
"telephone_number": "501-745-8784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PITTMAN",
"first_name": "JACK",
"middle_name": "DOWELL",
"name_suffix": "Jr.",
"credential": "DPH. GCP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-03-19",
"last_updated": "2014-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "OK",
"license": "9700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.