Organization
WESTERN ARKANSAS PLASTIC & RECONSTRUCTIVE SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES E KELLY III M.D. (OWNER)
(479) 709-8300
Entity
Organization
Contact information
Practice address
8101 MCCLURE DR STE 301, FORT SMITH, AR 72916-6056
(479) 709-8300
(479) 709-8315
Mailing address
PO BOX 10810, FORT SMITH, AR 72917-0810
(479) 709-8300
(479) 709-8315
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
E0847
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000480A
—
OK
05
—
130121001
—
AR
Enumeration date
07/29/2006
Last updated
01/08/2020
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