Healthcare Provider Details

I. General information

NPI: 1538538905
Provider Name (Legal Business Name): PHYSICIANS DAY SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2015
Last Update Date: 03/25/2024
Certification Date: 03/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2705 S ORLANDO ST
PINE BLUFF AR
71603-4718
US

IV. Provider business mailing address

10700 N RODNEY PARHAM RD STE C1-A
LITTLE ROCK AR
72212-4191
US

V. Phone/Fax

Practice location:
  • Phone: 870-536-4100
  • Fax: 870-536-9020
Mailing address:
  • Phone: 501-293-3626
  • Fax: 870-536-9020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateAR

VIII. Authorized Official

Name: HALLIE MUILENBURG
Title or Position: REV CYCLE
Credential:
Phone: 501-293-3626