Provider Demographics
NPI:1174748412
Name:NAVARRO, JENNY R (MD)
Entity type:Individual
Prefix:DR
First Name:JENNY
Middle Name:R
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 21850
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-1850
Mailing Address - Country:US
Mailing Address - Phone:501-767-9111
Mailing Address - Fax:501-767-3433
Practice Address - Street 1:2825 ALBERT PIKE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-7949
Practice Address - Country:US
Practice Address - Phone:501-767-9111
Practice Address - Fax:501-767-3433
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE5007207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR165247001Medicaid
AR165247001Medicaid
AR5N894OtherBLUE CROSS BLUE SHIELD