# RIDGELINE OBSTETRICS & GYNECOLOGY

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

## Provider details

- **NPI number:** 1548499684
- **Authorized official:** WALTER L DAVIS M.D. (SOLE MEMBER)
- **Authorized official phone:** (870) 633-0712

## Contact information

- **Practice address:** 1601 NEW CASTLE RD, FORREST CITY, AR 72335-2218
- **Practice address phone:** (870) 633-0712
- **Mailing address:** PO BOX 705, FORREST CITY, AR 72336-0705
- **Mailing address phone:** (870) 633-0712

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | E5242 | AR | Yes |

## Other

- **Enumeration date:** 07/10/2009
- **Last updated:** 07/13/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5N992 | BCBS PROVIDER NUMBER | AR |