Provider Demographics
NPI:1700106010
Name:OBGYN ASSOCIATES OF JONESBORO, INC.
Entity type:Organization
Organization Name:OBGYN ASSOCIATES OF JONESBORO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:870-932-7024
Mailing Address - Street 1:800 SOUTH CHURCH
Mailing Address - Street 2:SUITE 302
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-4107
Mailing Address - Country:US
Mailing Address - Phone:870-935-3990
Mailing Address - Fax:870-935-0871
Practice Address - Street 1:800 SOUTH CHURCH
Practice Address - Street 2:SUITE 302
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4107
Practice Address - Country:US
Practice Address - Phone:870-935-3990
Practice Address - Fax:870-935-0871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-09
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty