MEDICARE: JEFFREY J. CARSON, P.A.

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	111N00000X	Chiropractor	1013	AR

General Provider Information

NPI Number	:	1548539067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFFREY J. CARSON, P.A.

Provider Business Mailing Address
First Line	:	3907 CENTRAL AVE
Second Line	:	SUITE F
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-7210
Country	:	US
Telephone Number	:	501-525-7171
Fax Number	:	501-525-7171

Provider Business Practice Location Address
First Line	:	3907 CENTRAL AVE
Second Line	:	SUITE F
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-7210
Country	:	US
Telephone Number	:	501-525-7171
Fax Number	:	501-525-7171

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JEFFREY J CARSON
Credential	:	D.C.
Telephone Number	:	501-525-7171

Provider Enumeration Date	:	12/29/2011
Last Update Date	:	12/29/2011

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