# OPTIMUM AGING & INTEGRATED MEDICINE

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

## Provider details

- **NPI number:** 1508103029
- **Authorized official:** TERRY L HOYT D.O (OWNER)
- **Authorized official phone:** (479) 784-0011

## Contact information

- **Practice address:** 2641 ROGERS AVE, FORT SMITH, AR 72901-4145
- **Practice address phone:** (479) 784-0011
- **Practice address fax:** (479) 784-0012
- **Mailing address:** PO BOX 7132, VAN BUREN, AR 72956-0124
- **Mailing address phone:** (479) 784-0011
- **Mailing address fax:** (479) 784-0012

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2789 | OK | — |
| 207Q00000X | Family Medicine Physician | E-2638 | AR | Yes |

## Other

- **Enumeration date:** 01/04/2013
- **Last updated:** 05/14/2013