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Contact Information

JEFFERSON PULM CC PA
606 ROBERTS DRIVE
MONTICELLO, AR71655
 Phone: 870-850-6053
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for JEFFERSON PULM CC PA · (Female)

NPI Number 1396954228
Status Active
Credentials
Entity Individual
Enumeration date 05/21/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • AR License # E2334
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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