# ORTHOPAEDICS PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** River Valley Musculoskeletal Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619937745
- **Authorized official:** KEITH J BOLYARD M.D.. (PRESIDENT)
- **Authorized official phone:** (479) 709-6700

## Contact information

- **Practice address:** 3501 WE KNIGHT DR, FORT SMITH, AR 72903-6248
- **Practice address phone:** (479) 709-6700
- **Practice address fax:** (479) 709-6768
- **Mailing address:** PO BOX 11230, 3501 W. E. KNIGHT DRIVE, FORT SMITH, AR 72917-1230
- **Mailing address phone:** (479) 709-6767
- **Mailing address fax:** (479) 709-6768

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/24/2006
- **Last updated:** 10/03/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100756920A | — | OK |
| 01 | — | 1326160001 | CIGNA GOVERNMENT | AR |
| 05 | — | 140859002 | — | AR |
| 01 | — | CH0845 | RAILROAD MEDICARE | — |