Organization
ORTHOPAEDICS PA
Active
Other names
River Valley Musculoskeletal Center
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH J BOLYARD M.D.. (PRESIDENT)
(479) 709-6700
Entity
Organization
Contact information
Practice address
3501 WE KNIGHT DR, FORT SMITH, AR 72903-6248
(479) 709-6700
(479) 709-6768
Mailing address
PO BOX 11230, 3501 W. E. KNIGHT DRIVE, FORT SMITH, AR 72917-1230
(479) 709-6767
(479) 709-6768
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100756920A
—
OK
01
—
1326160001
CIGNA GOVERNMENT
AR
05
—
140859002
—
AR
01
—
CH0845
RAILROAD MEDICARE
—
Enumeration date
03/24/2006
Last updated
10/03/2008
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