Provider Demographics
NPI:1538538905
Name:PHYSICIANS DAY SURGERY CENTER
Entity type:Organization
Organization Name:PHYSICIANS DAY SURGERY CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REV CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:HALLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MUILENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-293-3626
Mailing Address - Street 1:10700 N RODNEY PARHAM RD STE C1-A
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-4191
Mailing Address - Country:US
Mailing Address - Phone:501-293-3626
Mailing Address - Fax:870-536-9020
Practice Address - Street 1:2705 S ORLANDO ST
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-4718
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:2015-09-16
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty