Organization Name: | JEFFERSON HEART, P.A. |
NPI Number: | 1164463253 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AYMAN ALSHAMI (ATTENDING PHYSICIAN) |
Mailing Address: | 1601 W 40th Ave Suite 301 Pine Bluff |
State: | AR US |
Postal Code: | 716036319 |
Phone Number: | 8705414285 |
Fax Number: | 8705414290 |
NPI Enumeration Date: | 06/09/2006 |
NPI Last Update Date: | 01/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | E-1795 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |