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General NPI Number Information
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NPI Number | 1306116777
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Entity Type | Organization
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Legal Business Name | ACCIDENT & INJURY CENTER OF SOUTH ARKANSAS
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Dates
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Enumeration Date | 01/03/2012
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Last Update Date | 01/03/2012
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Provider Practice Location Address
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Address Line | 431 E HILLSBORO ST
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City | EL DORADO
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State | AR
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Zip | 71730-7303
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Country | US
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Telephone | 870-862-2121
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Fax | 870-862-2116
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Provider Business Mailing Address
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Address Line | 431 E HILLSBORO ST
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City | EL DORADO
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State | AR
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Zip | 71730-7303
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Country | US
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Telephone | 870-862-2121
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Fax | 870-862-2116
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. JED FRISBY
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Credential | D.C.
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Telephone | 870-862-2121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1703
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License Number State | AR
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