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Organization

JEFFERSON HOSPITAL ASSOCIATION, INC.

Active
Other names
SOUTH ARKANSAS ORTHOPAEDIC CENTER
Organization subpart
No

Provider details

NPI number
Authorized official
WALTER E JOHNSON (PRESIDENT/CEO)
(870) 541-7269
Entity
Organization

Contact information

Practice address
1609 W 40TH AVE, SUITE 501, PINE BLUFF, AR 71603-6319
(870) 534-3449
(870) 535-3973
Mailing address
1609 W 40TH AVE, SUITE 501, PINE BLUFF, AR 71603-6319
(870) 534-3449
(870) 535-3973

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
185009002
AR
01
5G334
BCBS
AR
Enumeration date
09/23/2010
Last updated
01/25/2011
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