Provider Demographics
NPI:1801246129
Name:JAYROE, JOHN FREELAND (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:FREELAND
Last Name:JAYROE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 N UNIVERSITY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-2936
Mailing Address - Country:US
Mailing Address - Phone:501-664-4810
Mailing Address - Fax:501-663-1256
Practice Address - Street 1:701 N UNIVERSITY AVE STE 100
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2936
Practice Address - Country:US
Practice Address - Phone:501-664-4810
Practice Address - Fax:501-663-1256
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-17
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016020179207Q00000X
ARE-12211207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine