Blue Sea Medical Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

E-3012 Issued in AR

Legal business name

BLUE SEA MEDICAL CORPORATION

Practice address

1401 Braden St
Jacksonville, AR 72076-3720

Phone

(501) 985-2537

NPI assigned

Aug 10, 2012

Last updated

Jul 16, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Syed Ayub Mazher, MD

Title

Medical Director

Phone

(501) 256-7520

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary J Searcy, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Little Rock, AR
  • NPI 1730155284
  NPD (past)
• Gregory M Zawada, M.D.

  • Internal Medicine Physician
  • Sherwood, AR
  • NPI 1891704763
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1344556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405468800000",
    "number": "1508113309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 SEZANNE CT",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722235095",
            "telephone_number": "501-256-7520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 BRADEN ST",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720763720",
            "telephone_number": "501-985-2537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SEA MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-10",
        "last_updated": "2014-07-16",
        "status": "A",
        "authorized_official_last_name": "MAZHER",
        "authorized_official_first_name": "SYED",
        "authorized_official_middle_name": "AYUB",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "501-256-7520",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-3012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audrey Birge
• Abi Rachel Bishop-Taylor, LAC, LAMFT
• Cynthia Dale Blohm, CCC-SLP
• Blossom on Purpose Therapy & Consulting, LLC
• Gillian Blount, QBHP
• Body in Balance Massage Therapy & Esthetics, LLC
• Marissa Bolden
• Gregory K Bollen, DDS
• Susan Jean Bolls, MSE,CCC-SLP
• Sunita Sudhakar Bonde, DO

• Internal Medicine Physician in Jacksonville, AR
• Providers in Jacksonville, AR by specialty
• Internal Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.