DR. Kenneth Jake Sample, MD

NPI #1699358960 in Gravette, Arkansas

Provider Information

NPI Number: 1699358960
Entity Type: Individual
Name: DR. Kenneth Jake Sample, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Internal Medicine
Credential: MD
Enumeration Date: May 4, 2021
Last Updated: Aug 5, 2024

Practice Location

Address: 1101 JACKSON ST SW
City: Gravette
State: Arkansas
ZIP Code: 72736-9121
Phone: (479) 787-5221

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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