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General NPI Number Information
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NPI Number | 1730351941
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Entity Type | Organization
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Legal Business Name | JEFFERSON HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 1801 W 40TH AVE SUITE 4B
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City | PINE BLUFF
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State | AR
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Zip | 71603-6940
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Country | US
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Telephone | 870-535-4640
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 W 40TH AVE SUITE 4B
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City | PINE BLUFF
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State | AR
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Zip | 71603-6940
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Country | US
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Telephone | 870-535-4640
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT P ATKINSON
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Credential |
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Telephone | 870-541-7269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | E4113
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License Number State | AR
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