Provider Demographics
NPI:1386705747
Name:JAROS, JAMES P (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:P
Last Name:JAROS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72114-5328
Mailing Address - Country:US
Mailing Address - Phone:501-374-3335
Mailing Address - Fax:501-374-3335
Practice Address - Street 1:404 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-5328
Practice Address - Country:US
Practice Address - Phone:501-374-3335
Practice Address - Fax:501-374-3335
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2388152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR119866722Medicaid
AR121588722Medicaid
ART86114Medicare UPIN