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PINE BLUFF SURGICAL CLINIC INC NPI 1821148586


NPI Information

NPI: 1821148586
Provider Name: PINE BLUFF SURGICAL CLINIC, INC

Doing Business As: PROFESSIONAL MEDICAL REVIEW, INC

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
316 W 6TH AVE
PINE BLUFF, AR
ZIP 71601
Phone: (870) 850-6053
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PINE BLUFF SURGICAL CLINIC, INC is a specialist in Pine Bluff, AR. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PINE BLUFF SURGICAL CLINIC, INC NPI is 1821148586. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Professional Medical Review, Inc.

The provider's business location address is:

316 W 6TH AVE
PINE BLUFF, AR
ZIP 71601-217
Phone: (870) 850-6053
Fax: (870) 850-6482

The provider's authorized official is George Vaiden Roberson .
The authorized official title is President and has the following contact phone number (870) 850-6053.

The enumeration date for this NPI number is 1/12/2007 and was last updated on 4/29/2009.


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
1174400000XSpecialistR1682ARKANSASYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
156952MEDICARE PINARKANSAS
2103023002MEDICAIDARKANSAS
3544306952MEDICARE PINARKANSAS

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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