Blue Sea Medical Corporation | |
1401 Braden St Jacksonville AR 72076-3720 | |
(501) 985-2537 | |
Not Available |
Full Name | Blue Sea Medical Corporation |
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Speciality | Internal Medicine |
Location | 1401 Braden St, Jacksonville, Arkansas |
Authorized Official Name and Position | Syed Ayub Mazher (MEDICAL DIRECTOR) |
Authorized Official Contact | 5012567520 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Blue Sea Medical Corporation 112 Sezanne Ct Little Rock AR 72223-5095 Ph: (501) 256-7520 | Blue Sea Medical Corporation 1401 Braden St Jacksonville AR 72076-3720 Ph: (501) 985-2537 |
NPI Number | 1508113309 |
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Provider Enumeration Date | 08/10/2012 |
Last Update Date | 07/16/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508113309 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | E-3012 (Arkansas) | Primary |
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