# JEFFERSON HOSPITAL ASSOCIATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** INTERNAL MEDICINE SPECIALIST
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457436214
- **Authorized official:** MRS. BRENNA RENEE JACKSON (DIRECTOR OF CLINICS)
- **Authorized official phone:** (870) 541-7220

## Contact information

- **Practice address:** 4201 S MULBERRY ST, PINE BLUFF, AR 71603-7016
- **Practice address phone:** (870) 541-7220
- **Practice address fax:** (870) 541-8769
- **Mailing address:** 4201 S MULBERRY ST, PINE BLUFF, AR 71603-7016
- **Mailing address phone:** (870) 541-7220
- **Mailing address fax:** (870) 541-8769

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/27/2006
- **Last updated:** 07/02/2008