Organization
JEFFERSON HOSPITAL ASSN, INC.
Active
Other names
South Arkansas Cardiovascular Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER E. JOHNSON (CEO)
(870) 541-7269
Entity
Organization
Contact information
Practice address
1609 W 40TH AVE, SUITE 403, PINE BLUFF, AR 71603-6319
(870) 541-0668
(870) 541-0083
Mailing address
PO BOX 2320, PINE BLUFF, AR 71613-2320
(870) 541-5981
(870) 541-8730
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
C6122
AR
Other
Enumeration date
01/02/2013
Last updated
03/19/2015
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