<Unavail>

LBN: Jefferson Surgery Center Pllc
<Unavail> is an health care organization with primary practice located at 1609 W 40Th Ave Jrmc Professional Center, Suite 103, Pine Bluff AR 71603-6329. The organization recently has only one registered license in Ambulatory Health Care Facilities / Ambulatory Surgical, which is considered as the primary health care specialty. Jefferson Surgery Center Pllc can be contacted via phone (870) 541-3636, or through Bohannan, Crystal R via phone (870) 541-3640.

Contact Information

Primary practice address
1609 W 40Th Ave Jrmc Professional Center, Suite 103 Pine Bluff AR 71603-6329
Phone: (870) 541-3636
Fax: (870) 541-3639
Website:
Map and Directions
Authorized official contact:
Name: Bohannan, Crystal R CPA
Phone: (870) 541-3640

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Ambulatory Surgical 261QA1903X AR3637 Arkansas

Profile Details

NPI number 1710934542
LBN Legal business name Jefferson Surgery Center Pllc
DBA Doing business as <Unavail>
Authorized official Bohannan, Crystal R CPA
Entity Organization
Organization subpart 1 No
Enumeration date May 27th, 2006
Last updated Aug 26th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710934542 NPPES
Arkansas MEDICAID 135346128

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