# OZARK ORTHOPAEDICS, P.A.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194452409
- **Authorized official:** TRACY DAVENPORT (COO)
- **Authorized official phone:** (479) 587-3149

## Contact information

- **Practice address:** 3352 N FUTRALL DR, FAYETTEVILLE, AR 72703-4057
- **Practice address phone:** (479) 521-2752
- **Practice address fax:** (479) 521-4603
- **Mailing address:** 3317 N WIMBERLY DR, FAYETTEVILLE, AR 72703-4056
- **Mailing address phone:** (479) 521-2752
- **Mailing address fax:** (479) 521-4603

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |

## Other

- **Enumeration date:** 08/05/2022
- **Last updated:** 08/05/2022