| Internal Medicine Specialist | |
|
4201 S Mulberry St Pine Bluff AR 71603-7016 | |
| (870) 541-7220 | |
| (870) 541-8769 |
| Full Name | Internal Medicine Specialist |
|---|---|
| Speciality | Internal Medicine |
| Location | 4201 S Mulberry St, Pine Bluff, Arkansas |
| Authorized Official Name and Position | Brenna Renee Jackson (DIRECTOR OF CLINICS) |
| Authorized Official Contact | 8705417220 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Specialist 4201 S Mulberry St Pine Bluff AR 71603-7016 Ph: (870) 541-7220 | Internal Medicine Specialist 4201 S Mulberry St Pine Bluff AR 71603-7016 Ph: (870) 541-7220 |
| NPI Number | 1457436214 |
|---|---|
| Provider Enumeration Date | 10/27/2006 |
| Last Update Date | 07/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457436214 | NPI | - | NPPES |
| 163167002 | Medicaid | AR | |
| DF8389 | Other | AR | RAILROAD MEDICARE |
| 5F637 | Other | AR | BLUE CROSS BLUE SHEILD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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