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JEFFERSON HOSPITAL ASSOCIATION INC NPI 1497102040


NPI Information

NPI: 1497102040
Provider Name: JEFFERSON HOSPITAL ASSOCIATION, INC

Doing Business As: FAMILY HEALTH ASSOCIATES OF SOUTHEAST ARKANSAS

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 04D2115918

Address:
4747 DUSTY LAKE DR
SUITE 202
PINE BLUFF, AR
ZIP 71603
Phone: (870) 541-7235
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JEFFERSON HOSPITAL ASSOCIATION, INC is a family medicine in Pine Bluff, AR. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. JEFFERSON HOSPITAL ASSOCIATION, INC NPI is 1497102040. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Family Health Associates Of Southeast Arkansas.

The provider's business location address is:

4747 DUSTY LAKE DR
SUITE 202
PINE BLUFF, AR
ZIP 71603-742
Phone: (870) 541-7235

The provider's authorized official is Brian Thomas .
The authorized official title is Sr. Vp And Coo and has the following contact phone number (870) 541-7235.

The CLIA number assigned to this NPI record is 04D2115918 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/24/2016 and was last updated on 5/24/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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