Provider Demographics
NPI:1770742652
Name:HART, JEFFERY ALLEN (CRNA)
Entity type:Individual
Prefix:MR
First Name:JEFFERY
Middle Name:ALLEN
Last Name:HART
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3810 CENTRAL NE SUITE H
Mailing Address - Street 2:MIDSTATE ANESTHESIA
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913
Mailing Address - Country:US
Mailing Address - Phone:501-528-5840
Mailing Address - Fax:501-525-1762
Practice Address - Street 1:300 WERNER ST
Practice Address - Street 2:ST JOSEPHS HOSPITAL
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913
Practice Address - Country:US
Practice Address - Phone:501-622-1930
Practice Address - Fax:501-622-1925
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARR71248207L00000X
ARCTP000075207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology