Individual
DR. KEITH J BOLYARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3501 W. E. KNIGHT DRIVE, FORT SMITH, AR 72903-7994
(479) 709-6700
(479) 709-6730
Mailing address
PO BOX 11230, FORT SMITH, AR 72917-1230
(479) 709-6700
(479) 709-6730
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
C7460
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0920103
UNITED HEALTHCARE
AR
01
—
100024370A
OKLAHOMA MEDICAID
OK
05
—
138844001
—
AR
01
—
18030000000
QUALCHOICE
AR
01
—
200038806
RAILROAD MEDICARE
AR
01
—
3117278
CIGNA
AR
01
—
5160690
AETNA
AR
01
—
5K982
ARKANSAS BLUE CROSS
AR
01
—
904213
USA MCO
AR
Enumeration date
03/09/2006
Last updated
06/07/2016
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