Basic Information
| Provider Information | |||||||||
| NPI: | 1811494974 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAWKINS | ||||||||
| FirstName: | JHEANELLE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11001 EXECUTIVE CENTER DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722114393 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 0183507035 | ||||||||
| FaxNumber: | 5018331716 | ||||||||
| Practice Location | |||||||||
| Address1: | 1308 E KIEHL AVE | ||||||||
| Address2: | |||||||||
| City: | SHERWOOD | ||||||||
| State: | AR | ||||||||
| PostalCode: | 721203040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5018350703 | ||||||||
| FaxNumber: | 5018331716 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2018 | ||||||||
| LastUpdateDate: | 10/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QA0505X | E-12767 | AR | Y | Allopathic & Osteopathic Physicians | Family Medicine | Adult Medicine |
No ID Information.