Organization
JEFFERSON PULM CC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA M SIMPSON (PRESIDENT)
(870) 850-6053
Entity
Organization
Contact information
Practice address
606 ROBERTS DRIVE, MONTICELLO, AR 71655
(870) 850-6053
Mailing address
PO BOX 7824, PINE BLUFF, AR 71611-7824
(870) 850-6053
(870) 850-6482
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
E2334
AR
Other
Enumeration date
05/21/2007
Last updated
08/22/2020
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