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Organization
BLUE SEA MEDICAL CORPORATION
Active
Organization
BLUE SEA MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SYED AYUB MAZHER MD (MEDICAL DIRECTOR)
(501) 256-7520
Entity
Organization
Contact information
Practice address
1401 BRADEN ST, JACKSONVILLE, AR 72076-3720
(501) 985-2537
Mailing address
112 SEZANNE CT, LITTLE ROCK, AR 72223-5095
(501) 256-7520
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E-3012
AR
Other
Enumeration date
08/10/2012
Last updated
07/16/2014
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