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Organization

JONESBORO SURGERY CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANGIE CARLTON (ADMINISTRATOR)
(870) 932-2211
Entity
Organization

Contact information

Practice address
623 E MATTHEWS AVE, SUITE C, JONESBORO, AR 72401-3145
(870) 934-8010
Mailing address
623 E MATTHEWS AVE, SUITE C, JONESBORO, AR 72401-3145

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
AR3943
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11048
AR BLUE CROSS BLUE SHIELD
AR
05
143775128
AR
01
490005365
RAILROAD MEDICARE
Enumeration date
07/18/2006
Last updated
06/30/2025
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