JONESBORO SURGERY CENTER LLC NPI 1457379364

NPI Information

NPI: 1457379364
Provider Name: JONESBORO SURGERY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
623 E MATTHEWS AVE
SUITE C
JONESBORO, AR
ZIP 72401
Phone: (870) 934-8010
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JONESBORO SURGERY CENTER, LLC is an ambulatory surgical clinic center in Jonesboro, AR. JONESBORO SURGERY CENTER, LLC NPI is 1457379364. The provider is registered as an organization entity type.

The provider's business location address is:

623 E MATTHEWS AVE
SUITE C
JONESBORO, AR
ZIP 72401-145
Phone: (870) 934-8010

The provider's authorized official is Jacqueline Wheeler .
The authorized official title is Clinical Director and has the following contact phone number (870) 934-8010.

The enumeration date for this NPI number is 7/18/2006 and was last updated on 4/28/2008.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	AR3943	ARKANSAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	11048	OTHER	ARKANSAS	AR BLUE CROSS BLUE SHIELD
2	=========50	OTHER		QUALCHOICE/QCA
3	11048	MEDICARE ID-TYPE UNSPECIFIED	ARKANSAS
4	143775128	MEDICAID	ARKANSAS
5	490005365	OTHER		RAILROAD MEDICARE
6	11048	MEDICARE PIN	ARKANSAS

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

NPI Synchronization or Removal

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