Jefferson Surgery Center Pllc
Jefferson Surgery Center Pllc is a healthcare organization registered as Ambulatory Surgical Clinic/Center in Pine Bluff, AR, holding Type 2 (organization) NPI 1710934542 since 2006. The authorized official on file is Crystal Bohannan, Administrator.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1710934542 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Jefferson Surgery Center Pllc |
| Other name | <Unavail> |
| Practice address | 1609 W 40TH AVE, JRMC PROFESSIONAL CENTER, SUITE 103, Pine Bluff, AR, 71603 |
| Phone | 8705413636 |
| Fax | 8705413639 |
| Enumeration date | 2006-05-27 |
| Last updated in NPPES | 2008-08-26 |
Authorized official
| Name | Crystal Bohannan |
|---|---|
| Title | Administrator |
| Phone | 8705413640 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261QA1903X | Ambulatory Surgical Clinic/Center | Primary | AR3637 | AR |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 135346128 | Medicaid | AR | — |
Copy-ready billing details
Provider: Jefferson Surgery Center Pllc NPI: 1710934542 Taxonomy: 261QA1903X (Ambulatory Surgical Clinic/Center) Address: 1609 W 40TH AVE, JRMC PROFESSIONAL CENTER, SUITE 103, Pine Bluff, AR, 71603
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1740272004 | David Silas | Individual | Neurology Physician | Pine Bluff, AR |
| 1013909316 | Dennis Jacks | Individual | Urology Physician | Pine Bluff, AR |
| 1245222553 | David Lupo | Individual | Urology Physician | Pine Bluff, AR |
| 1992799555 | James Pollard | Individual | Orthopaedic Surgery Physician | Pine Bluff, AR |
| 1336133826 | Heather Leblanc | Individual | Vascular Surgery Physician | Pine Bluff, AR |
| 1891780219 | John Lytle | Individual | Orthopaedic Surgery Physician | Pine Bluff, AR |
| 1043205461 | Charles Clark | Individual | Orthopaedic Surgery Physician | Pine Bluff, AR |
| 1215917075 | P Simpson | Individual | Specialist | Pine Bluff, AR |
Verify this record
Cross-check NPI 1710934542 against the authoritative CMS record: view Jefferson Surgery Center Pllc on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Where is Jefferson Surgery Center Pllc located?
How current is this record?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2008-08-26.