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Organization
OZARK ORTHOPAEDICS, P.A.
Active
Organization
OZARK ORTHOPAEDICS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY DAVENPORT (COO)
(479) 587-3149
Entity
Organization
Contact information
Practice address
3352 N FUTRALL DR, FAYETTEVILLE, AR 72703-4057
(479) 521-2752
(479) 521-4603
Mailing address
3317 N WIMBERLY DR, FAYETTEVILLE, AR 72703-4056
(479) 521-2752
(479) 521-4603
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Enumeration date
08/05/2022
Last updated
08/05/2022
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