Organization
OZARK REGIONAL ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS JAY DAVIS MD (PRESIDENT)
(918) 728-6145
Entity
Organization
Contact information
Practice address
3215 N NORTHHILLS BLVD, FAYETTEVILLE, AR 72703-4424
(479) 463-1019
Mailing address
PO BOX 1867, FAYETTEVILLE, AR 72702-1867
(918) 664-9892
(918) 664-2521
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100728380A
—
OK
05
—
135928002
—
AR
Enumeration date
12/01/2005
Last updated
02/10/2012
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