Kenneth Jake Sample, MD Valid NPI

Individual provider · Internal Medicine Physician · Gravette, AR

NPI

1699358960

Type

Individual (Type 1)

Primary specialty

Internal Medicine Physician (Internal Medicine)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207R00000X

License number

E-18299 (AR)

Sex

Male

Sole proprietor

No

Enumerated

2021-05-04

Last updated

2024-08-05