# JEFFERSON HOSPITAL ASSOCIATION, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Family Health Assoc of Southeast AR
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922578327
- **Authorized official:** MR. BRYAN JACKSON CFO (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (870) 541-7141

## Contact information

- **Practice address:** 1801 W 40TH AVE STE 6A, PINE BLUFF, AR 71603-6963
- **Practice address phone:** (870) 541-9373
- **Practice address fax:** (870) 541-0109
- **Mailing address:** PO BOX 2650, PINE BLUFF, AR 71613-2650
- **Mailing address phone:** (870) 541-7235

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/28/2018
- **Last updated:** 11/28/2018