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Organization
OZARK ORTHOPAEDICS, P.A.
Active
Organization
OZARK ORTHOPAEDICS, P.A.
Active
Parent organization
OZARK ORTHOPAEDICS, P.A.
Other names
Othopaedic Clinic, Ltd., OZARK ORTHOPAEDICS
Organization subpart
Yes
Provider details
NPI number
Legal business name
OZARK ORTHOPAEDICS, P.A.
Authorized official
DR. TOM PAT COKER M.D. (PRESIDENT OF CORPORATION)
(479) 521-2752
Entity
Organization
Contact information
Practice address
1800 SE MOBERLY LN, STE B, BENTONVILLE, AR 72712-7017
(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
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0290210002
CIGNA MEDICARE DURABLE MEDICAL EQUIPMENT PTAN
AR
Enumeration date
04/17/2013
Last updated
07/06/2020
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