Organization
JEFFERSON HOSPITAL ASSOCIATION, INC
Active
Other names
Jefferson Regional Healthworks
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN JACKSON (VP/CHIEF ADMIN OFFICER)
(870) 541-7141
Entity
Organization
Contact information
Practice address
4201 S MULBERRY ST STE A, PINE BLUFF, AR 71603-7002
(870) 536-6600
(870) 534-1519
Mailing address
4201 S MULBERRY ST STE A, PINE BLUFF, AR 71603-7002
(870) 536-6600
(870) 541-8623
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56802
BLUE CROSS BLUE SHIELD
AR
01
—
CI2242
RAILROAD MEDICARE
AR
Enumeration date
06/17/2006
Last updated
04/12/2023
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