JT Dewitt D.O.P.a.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

E4975 Issued in AR

Legal business name

JT DEWITT D.O.P.A.

Doing business as

DeWitt Family Medical Clinic

Practice address

11998 Highway 49 N
Marmaduke, AR 72443-9597

Phone

(870) 897-8433

Fax

(870) 897-8438

NPI assigned

Mar 24, 2014

Last updated

Mar 24, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. JT Dewitt Jr., D.O.

Title

Ceo

Phone

(870) 897-8433

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DeWitt Family Medical Clinic Doing business as

Tax ID family

Dewitt Family Medical Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• JT Dewitt D.O.P.a

  dba Synergy Elite Medical

  • Family Medicine Physician
  • Paragould, AR
  • NPI 1619413127
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395619200000",
    "number": "1639596091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3071 HIGHWAY 34 E",
            "city": "MARMADUKE",
            "state": "AR",
            "postal_code": "724439773",
            "telephone_number": "870-897-8433",
            "fax_number": "870-897-8438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11998 HIGHWAY 49 N",
            "city": "MARMADUKE",
            "state": "AR",
            "postal_code": "724439597",
            "telephone_number": "870-897-8433",
            "fax_number": "870-897-8438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JT DEWITT D.O.P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-24",
        "last_updated": "2014-03-24",
        "status": "A",
        "authorized_official_last_name": "DEWITT",
        "authorized_official_first_name": "JT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "870-897-8433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AR",
            "license": "E4975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175408003",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeWitt Family Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Access Medical Clinic Arkansas LLC
• Eddington Pharmaceuticals Inc (Marmaduke Family Pharmacy)
• Eddington Pharmaceuticals Inc (Marmaduke Family Pharmacy)
• Ember & Bloom PLLC
• Sadie Evans, MHPP
• JT Dewitt, D.O., P.a. (DeWitt Family Medical)
• Derek James Layton
• Marmaduke High School
• Marmaduke Pharmacy, LLC
• Marmaduke Pharmacy, LLC (Marmaduke Pharmacy)

• Primary Care Clinic/Center in Marmaduke, AR
• Providers in Marmaduke, AR by specialty
• Primary Care Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.

Verify at the official NPI Registry.