Organization
OZARK FOOT & ANKLE PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES JAY BRANTLEY DPM (MANAGING MEMBER)
(479) 549-3835
Entity
Organization
Contact information
Practice address
500 S MOUNT OLIVE ST, SUITE 201, SILOAM SPRINGS, AR 72761-3602
(479) 549-3835
(479) 549-4146
Mailing address
PO BOX 8728, FAYETTEVILLE, AR 72703-0013
(479) 549-3835
(479) 549-4146
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
152
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
811005690
SECRETARY OF STATE- DEPT OF CORPORATIONS
AR
Enumeration date
11/08/2011
Last updated
08/09/2013
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