Jack T Fendley
Medical Specialty
Professional ID
- NPI: 1821074592
- PECOS ID: 3971786013
- Enrollment ID: I20110404000839
- Credential(MD, DO, DPM):
- Medical School:
- Medical School Graduation Year: 1972
Hospital Service
- Hospital CCN1: 040137
- Business Name (LBN)1: St Vincent Medical Centernorth
- Hospital CCN2: 040036
- Business Name (LBN)2: Baptist Health Medical Center North Little Rock
- Hospital CCN3: 040114
- Business Name (LBN)3: Baptist Health Medical Center-little Rock
- Hospital CCN4: 040007
- Business Name (LBN)4: Chi-st Vincent Infirmary
- Hospital CCN5: 041313
- Business Name (LBN)5: Ozark Health
Medical Practices
- Organization Name: North Pulaski Diagnostic Clinic
- Group Practice ID assigned by PECOS: 8527241660
- Number of Group Practice member: 3
Location
- Address1: 2215 Wildwood Ave
- Address2: Suite 201
- City: Sherwood
- State: Arkansas
- Zip Code: 72120
- Phone Number: (501)833-8400
Medicare
- Medicare Assignment: Yes
- Report Quality of Care to Physician Quality Reporting System (PQRS): Yes
- Used Electronic health record (EHR): Yes