NPIMap

Organization Active NPI

Surgeons of South Arkansas, PA

  • Surgery Physician
  • Pine Bluff, AR
National Provider Identifier
1952367625
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
C4953 Issued in AR
Legal business name
SURGEONS OF SOUTH ARKANSAS, PA
Practice address
1801 W 40TH Ave
Ste 7B
Pine Bluff, AR 71603-6900
Phone
(870) 535-8280
NPI assigned
Apr 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Charles D Mabry, MDNPI 1225026875
Title
Pres
Phone
(870) 535-8280

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X C4953 AR Primary

Addresses

Primary practice location

1801 W 40TH Ave
Ste 7B
Pine Bluff, AR 71603-6900

Mailing address

1801 W 40TH Ave
Ste 7B
Pine Bluff, AR 71603-6900
Phone (870) 535-8280

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952367625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W 40TH AVE",
            "address_2": "STE 7B",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036900",
            "telephone_number": "870-535-8280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W 40TH AVE",
            "address_2": "STE 7B",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036900",
            "telephone_number": "870-535-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGEONS OF SOUTH ARKANSAS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MABRY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "870-535-8280",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "C4953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.