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Contact Information

JARED ENNIS, MD
4019 N REMINGTON DR
FAYETTEVILLE, AR72703-6344
 Phone: 479-595-8192
 Fax: 479-442-1748
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for JARED ENNIS · (Male)

NPI # 1467539155
Status Active
Credentials MD
Entity Individual
Enumeration date 11/01/2006
Last updated 03/29/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • AR License # E-4271
  • AR Medicaid 157891001
Hospital affiliation(s)
  • WASHINGTON REGIONAL MED CTR AT NORTH HILLS - (Acute Care)
    3215 N NORTH HILLS BLVD
    FAYETTEVILLE, AR 72703
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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