Basic Information
| Provider Information | |||||||||
| NPI: | 1285865154 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARLOW | ||||||||
| FirstName: | KEREEM | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3508 LAUREL RIDGE CV | ||||||||
| Address2: | |||||||||
| City: | JONESBORO | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724048354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5015175979 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4800 E JOHNSON AVE | ||||||||
| Address2: | |||||||||
| City: | JONESBORO | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724018413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8709361000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2009 | ||||||||
| LastUpdateDate: | 11/02/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | A142540 | CA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | 4301095067 | MI | N | Allopathic & Osteopathic Physicians | Family Medicine | 207P00000X | E-7968 | AR | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.