Organization
MID-SOUTH NEUROSURGERY, INC.
Active
Organization
MID-SOUTH NEUROSURGERY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. J MATT PARKER (PRESIDENT)
(870) 932-7024
Entity
Organization
Contact information
Practice address
800 S. CHURCH, SUITE 203, JONESBORO, AR 72401
(870) 932-3850
(870) 932-5699
Mailing address
P.O. BOX 6004, JONESBORO, AR 72403
(870) 932-3850
(870) 932-5699
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC9398
RAILROAD
AR
Enumeration date
04/11/2006
Last updated
08/22/2020
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