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Contact Information

JEFFERSON HOSPITAL ASSOCIATION, INC
1601 W 40TH
SUITE 301
PINE BLUFF, AR71603
 Phone: 870-541-7220
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for JEFFERSON HOSPITAL ASSOCIATION INC · (Female)

NPI Number 1174542906
Status Active
Credentials
Entity Individual
Enumeration date 07/19/2006
Last updated 03/18/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • AR License # E-4501
  • AR Medicaid 163127002
  • AR Other 5F630 BCBS
  • AR Other DF4052 RAILROAD MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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