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General NPI Number Information
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NPI Number | 1306897574
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Entity Type | Organization
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Legal Business Name | THE SURGICAL HOSPITAL OF JONESBORO
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Dates
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Enumeration Date | 05/13/2006
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Last Update Date | 12/05/2007
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Provider Practice Location Address
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Address Line | 909 ENTERPRISE DR
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City | JONESBORO
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State | AR
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Zip | 72401-9201
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Country | US
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Telephone | 870-336-1100
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Fax | 870-336-1013
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Provider Business Mailing Address
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Address Line | 909 ENTERPRISE DR
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City | JONESBORO
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State | AR
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Zip | 72401-9201
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Country | US
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Telephone | 870-336-1100
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Fax | 870-336-1013
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Authorized Official
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Title or Position | CEO
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Name | MR. NATE MILLER
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Credential |
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Telephone | 870-336-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | AR4164
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License Number State | AR
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