Organization
EXECUTIVE PARK SURGERY CENTER OF FORT SMITH, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER J RODRIGUEZ M.D. (PRESIDENT)
(479) 424-2744
Entity
Organization
Contact information
Practice address
3314 S 70TH ST, FORT SMITH, AR 72903-5052
(479) 424-2744
(479) 424-2745
Mailing address
3314 S 70TH ST, FORT SMITH, AR 72903-5052
(479) 424-2744
(479) 424-2745
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
APPLIED FOR
AR
Other
Enumeration date
12/16/2010
Last updated
01/04/2024
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