National Provider Identifier Database

JEFFERSON HOSPITAL ASSOCIATION INC
Cardiovascular Disease

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.


Contact Information

JEFFERSON HOSPITAL ASSOCIATION, INC
1601 W 40TH
SUITE 301
PINE BLUFF, AR71603
Phone: 870-541-7220
Fax:
Website:
Specialty Taxonomy Code
* Cardiovascular Disease 207RC0000X

* Indicates primary specialty

NPI Profile & details for JEFFERSON HOSPITAL ASSOCIATION, INC

NPI Number 1174542906
Legal business name
LBN
JEFFERSON HOSPITAL ASSOCIATION, INC
Authorized official WALTER JOHNSON - (CEO)
Entity Organization
Organization subpart No
Enumeration date 07/19/2006
Last updated 03/18/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • AR License #: E-4501
  • AR Medicaid: 163127002
  • AR Other: 5F630 BCBS
  • AR Other: DF4052 RAILROAD MEDICARE

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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