Provider Demographics
NPI:1447286711
Name:HOSKYN, JERRI (MD)
Entity type:Individual
Prefix:DR
First Name:JERRI
Middle Name:
Last Name:HOSKYN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S UNIVERSITY AVE
Mailing Address - Street 2:SUITE 716
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5302
Mailing Address - Country:US
Mailing Address - Phone:501-228-4664
Mailing Address - Fax:501-228-0011
Practice Address - Street 1:500 S UNIVERSITY AVE
Practice Address - Street 2:SUITE 716
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5302
Practice Address - Country:US
Practice Address - Phone:501-228-4664
Practice Address - Fax:501-228-0011
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-25
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE4090207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR154235001Medicaid
AR040700143OtherQUALCHOICE
AR5M856OtherBLUE CROSS/BLUE SHIELD