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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

NPI # 1396954228
LBN Legal business name JEFFERSON PULM CC PA
Authorized official TANYA SIMPSON - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 05/21/2007
Last updated 08/22/2020 - About 6 years ago
Identifiers
AR License # E2334
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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