Organization
JEFFERSON HOSPITAL ASSOCIATION INC
Active
Other names
Watson Chapel Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
NARDA JO SMITHEY (OFFICE COORDINATOR)
(870) 879-3517
Entity
Organization
Contact information
Practice address
4747 DUSTY LAKE DR, SUITE 202, PINE BLUFF, AR 71603-8742
(870) 879-3517
(870) 879-6049
Mailing address
4747 DUSTY LAKE DR, SUITE 202, PINE BLUFF, AR 71603-8742
(870) 879-3517
(870) 879-6049
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CU0295
RAILROAD MEDICARE
—
Enumeration date
06/10/2006
Last updated
04/20/2008
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