Accident & Injury Center of South Arkansas
Organization Active NPI Chiropractor · El Dorado, AR
NPI 1306116777 · NPPES record last updated Jan 3, 2012
Key facts
- NPI
- 1306116777
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1703 (AR)
- Legal business name
- ACCIDENT & INJURY CENTER OF SOUTH ARKANSAS
- Practice address
- 431 E Hillsboro St
El Dorado, AR 71730-7303 - Phone
- (870) 862-2121
- Fax
- (870) 862-2116
- NPI assigned
- Jan 3, 2012
- Organization subpart
- No
Authorized official
- Name
- Dr. Jed Frisby, D.C.
- Title
- Owner/Chiropractor
- Phone
- (870) 862-2121
Practitioners 2
-
Jed Frisby, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120326000043 | AR | Part B Supplier - Clinic/Group Practice | 1052571304 |
Receives reassigned benefits from 1 practitioner Practice locations: El Dorado, AR |
National Provider Directory
Locations
431 E Hillsboro St
El Dorado, AR 71730
Phone (870) 862-2121
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 1703 | AR | Yes |
Addresses
Primary practice location
431 E Hillsboro St
El Dorado, AR 71730-7303
Mailing address
431 E Hillsboro St
El Dorado, AR 71730-7303
Phone (870) 862-2121
Other providers in El Dorado, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.