Provider Demographics
NPI:1568681211
Name:PHYSICIAN'S SLEEP INSTITUTE
Entity Type:Organization
Organization Name:PHYSICIAN'S SLEEP INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:FRIGON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-535-4800
Mailing Address - Street 1:1801 W 40TH
Mailing Address - Street 2:SUITE 5B
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603
Mailing Address - Country:US
Mailing Address - Phone:870-535-4800
Mailing Address - Fax:870-535-4804
Practice Address - Street 1:4747 DUSTY LAKE RD.
Practice Address - Street 2:SUITE 204
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603
Practice Address - Country:US
Practice Address - Phone:870-879-6571
Practice Address - Fax:870-879-6572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARP00136400OtherPALMETTO GBA
P00136400OtherPALMETTO, GBA
AR49855OtherBCBS
ARP00136400OtherPALMETTO GBA