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Contact Information

KATIE DEFORE, MD
225 E JACKSON AVE
JONESBORO, AR72401-3119
 Phone: 870-972-4100
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for KATIE DEFORE · (Female)

NPI # 1932220902
Status Active
Credentials MD
Entity Individual
Enumeration date 04/03/2007
Last updated 04/13/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • AR License # E4912
  • VA Medicaid 1932220902
  • VA Other 0101245807 STATE LICENSE
Hospital affiliation(s) Not Available
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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