Organization
JEFFERSON HOSPITAL ASSOCIATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN JACKSON (CFO)
(870) 541-7141
Entity
Organization
Contact information
Practice address
1420 W 43RD AVE, PINE BLUFF, AR 71603-7010
(870) 534-6210
(870) 534-8620
Mailing address
PO BOX 2650, PINE BLUFF, AR 71613-2650
(870) 541-7235
(870) 541-4297
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Enumeration date
11/13/2018
Last updated
11/13/2018
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