Provider Demographics
NPI:1407274277
Name:STOVALL, JESSICA (MD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:STOVALL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 SPRINGHILL DR STE 400
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2008
Mailing Address - Country:US
Mailing Address - Phone:501-945-8838
Mailing Address - Fax:501-945-8835
Practice Address - Street 1:3201 SPRINGHILL DR STE 400
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2008
Practice Address - Country:US
Practice Address - Phone:501-945-8838
Practice Address - Fax:501-945-8835
Is Sole Proprietor?:No
Enumeration Date:2014-03-31
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ARE-111272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program