| Jefferson Regional Healthworks | |
|
4201 S Mulberry St Ste A Pine Bluff AR 71603-7002 | |
| (870) 536-6600 | |
| (870) 534-1519 |
| Full Name | Jefferson Regional Healthworks |
|---|---|
| Speciality | Clinic/Center |
| Location | 4201 S Mulberry St Ste A, Pine Bluff, Arkansas |
| Authorized Official Name and Position | Bryan Jackson (VP/CHIEF ADMIN OFFICER) |
| Authorized Official Contact | 8705417141 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Regional Healthworks 4201 S Mulberry St Ste A Pine Bluff AR 71603-7002 Ph: (870) 536-6600 | Jefferson Regional Healthworks 4201 S Mulberry St Ste A Pine Bluff AR 71603-7002 Ph: (870) 536-6600 |
| NPI Number | 1841235868 |
|---|---|
| Provider Enumeration Date | 06/17/2006 |
| Last Update Date | 04/12/2023 |
| Medicare PECOS PAC ID | 8123927431 |
|---|---|
| Medicare Enrollment ID | O20070913000776 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841235868 | NPI | - | NPPES |
| 56802 | Other | AR | BLUE CROSS BLUE SHIELD |
| CI2242 | Other | AR | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Arkansas) | Primary |
| Provider Name | Holly H Handloser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497866149 PECOS PAC ID: 0042390718 Enrollment ID: I20080108000133 |
| Provider Name | Roslyn D Burks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861685570 PECOS PAC ID: 0345325478 Enrollment ID: I20080312000723 |
| Provider Name | Lester Alexander |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306882501 PECOS PAC ID: 2264616580 Enrollment ID: I20110412000398 |
| Provider Name | Lillian Jynes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033557145 PECOS PAC ID: 8628387362 Enrollment ID: I20151021000935 |
| Provider Name | Priscilla C Beasley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144681883 PECOS PAC ID: 9335438506 Enrollment ID: I20160512000224 |
| Provider Name | Elizabeth Hartz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932879350 PECOS PAC ID: 9234537622 Enrollment ID: I20211015001373 |
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