JEFFERSON PULM CC PA NPI 1396954228

NPI Information

JEFFERSON PULM CC PA is a pulmonary disease internal medicine in Monticello, AR. The provider is an internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. JEFFERSON PULM CC PA NPI is 1396954228. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

606 ROBERTS DRIVE
MONTICELLO, AR
ZIP 71655
Phone: (870) 850-6053

The provider's authorized official is Tanya M Simpson .
The authorized official title is President and has the following contact phone number (870) 850-6053.

The CLIA number assigned to this NPI record is 04D2176842 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/21/2007 and was last updated on 8/22/2020.

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:

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