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Organization
COOPER CLINIC, PA
Active
Organization
COOPER CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CURTIS D RALSTON (CEO)
(479) 274-2000
Entity
Organization
Contact information
Practice address
20 N ASTER ST, GREENWOOD, AR 72936-3145
(479) 996-4111
(479) 484-4793
Mailing address
PO BOX 3528, FORT SMITH, AR 72913-3528
(479) 274-2000
(479) 274-2194
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MC-0254
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125017002
—
AR
Enumeration date
07/24/2006
Last updated
09/01/2015
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