MEDICARE: PHYSICIANS DAY SURGERY CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician		AR

General Provider Information

NPI Number	:	1538538905
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIANS DAY SURGERY CENTER

Provider Business Mailing Address
First Line	:	10700 N RODNEY PARHAM RD STE C1-A
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72212-4191
Country	:	US
Telephone Number	:	501-293-3626
Fax Number	:	870-536-9020

Provider Business Practice Location Address
First Line	:	2705 S ORLANDO ST
Second Line	:
City	:	PINE BLUFF
State	:	AR
Zip	:	71603-4718
Country	:	US
Telephone Number	:	870-536-4100
Fax Number	:	870-536-9020

Authorized Official
Title or Position	:	REV CYCLE
Name	:	HALLIE MUILENBURG
Credential	:
Telephone Number	:	501-293-3626

Provider Enumeration Date	:	09/16/2015
Last Update Date	:	03/25/2024

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Directions to “PHYSICIANS DAY SURGERY CENTER ” Practice Location

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