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General NPI Number Information
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NPI Number | 1811368327
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Entity Type | Organization
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Legal Business Name | JONESBORO ANESTHESIA SERVICES LLC
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Dates
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Enumeration Date | 10/09/2015
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 601 E MATTHEWS AVE
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City | JONESBORO
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State | AR
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Zip | 72401-3145
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Country | US
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Telephone | 870-935-6396
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Fax | 970-935-4063
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Provider Business Mailing Address
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Address Line | 601 E MATTHEWS AVE
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City | JONESBORO
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State | AR
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Zip | 72401-3145
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Country | US
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Telephone | 870-935-6396
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Fax | 870-932-6541
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DONNA RENEE COLBERT
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Credential |
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Telephone | 870-935-6396
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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