Organization
COOPER CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CURTIS RALSTON (CEO)
(479) 274-2000
Entity
Organization
Contact information
Practice address
690 N KENNEDY AVE RM 1, BOONEVILLE, AR 72927-3240
(479) 274-2000
(479) 274-2194
Mailing address
PO BOX 3528, FORT SMITH, AR 72913-3528
(479) 274-2000
(479) 274-2194
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/30/2014
Last updated
09/01/2015
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