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Organization
JEFFERSON HOSPITAL ASSN, INC.
Active
Organization
JEFFERSON HOSPITAL ASSN, INC.
Active
Other names
South Arkansas Cardiovascular Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER E. JOHNSON (CEO)
(870) 541-7269
Entity
Organization
Contact information
Practice address
1609 W 40TH AVE, SUITE 403, PINE BLUFF, AR 71603-6319
(870) 541-0668
(870) 541-0083
Mailing address
PO BOX 2320, PINE BLUFF, AR 71613-2320
(870) 541-5981
(870) 541-8730
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
C6122
AR
Other
Enumeration date
01/02/2013
Last updated
03/19/2015
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