Organization
JEFFERSON HOSPITAL ASSOCIATION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER AUSTIN (COO)
(870) 541-7100
Entity
Organization
Contact information
Practice address
1601 W 40TH AVE, SUITE 301, PINE BLUFF, AR 71603-6319
(870) 879-3007
(870) 879-3008
Mailing address
PO BOX 2650, PINE BLUFF, AR 71613-2650
(870) 541-7211
(870) 541-4297
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207RN0300X
Nephrology Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
207RR0500X
Rheumatology Physician
—
—
207VX0000X
Obstetrics Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208000000X
Pediatrics Physician
—
—
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152571002
—
AR
Enumeration date
05/05/2006
Last updated
07/12/2023
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