Provider Demographics
NPI:1588603351
Name:PHYSICIAN'S DAY SURGERY CENTER
Entity Type:Organization
Organization Name:PHYSICIAN'S DAY SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-536-4100
Mailing Address - Street 1:2705 S ORLANDO ST
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-4718
Mailing Address - Country:US
Mailing Address - Phone:870-536-4100
Mailing Address - Fax:870-536-9020
Practice Address - Street 1:17200 CHENAL PKWY STE 440
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-5970
Practice Address - Country:US
Practice Address - Phone:870-536-4100
Practice Address - Fax:870-536-9020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR4179261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical