Healthcare Provider Details
I. General information
NPI: 1912374018
Provider Name (Legal Business Name): SOUTHEAST ARKANSAS HOSPITALISTS, LLP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/25/2015
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 W 40TH AVE
PINE BLUFF AR
71603-6301
US
IV. Provider business mailing address
200 CORPORATE BLVD
LAFAYETTE LA
70508-3870
US
V. Phone/Fax
- Phone: 870-541-7100
- Fax:
- Phone: 800-893-9698
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
S
SCHILLINGER
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 800-893-9698