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Organization
OZARK MOUNTAIN ORTHOPEDIC CLINIC, PA
Active
Organization
OZARK MOUNTAIN ORTHOPEDIC CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ARTHUR WALLER M.D. (PRESIDENT)
(501) 362-6631
Entity
Organization
Contact information
Practice address
1708 W MAIN ST, HEBER SPRINGS, AR 72543-2823
(501) 362-6631
Mailing address
1708 W MAIN ST, HEBER SPRINGS, AR 72543-2823
(501) 362-6631
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
R-4651
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140217001
—
AR
Enumeration date
12/13/2006
Last updated
05/19/2009
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