Provider Demographics
NPI:1801424510
Name:JEFFERSON, ERIN ELIZABETH YANCEY (MD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:ELIZABETH YANCEY
Last Name:JEFFERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ERIN
Other - Middle Name:ELIZABETH
Other - Last Name:YANCEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4301 W MARKHAM ST # 783
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7101
Mailing Address - Country:US
Mailing Address - Phone:501-686-8000
Mailing Address - Fax:501-526-5148
Practice Address - Street 1:4224 SHUFFIELD DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7211
Practice Address - Country:US
Practice Address - Phone:501-526-8200
Practice Address - Fax:501-526-5296
Is Sole Proprietor?:No
Enumeration Date:2020-03-29
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-177962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry