Organization
OZARK ORTHOPAEDICS, P.A.
Active
Other names
Orthopaedic Clinic, Ltd., OZARK ORTHOPAEDICS
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY DAVENPORT (DIRECTOR OF OPERATIONS)
(479) 587-3149
Entity
Organization
Contact information
Practice address
603-2 N PROGRESS AVE STE 600, SILOAM SPRINGS, AR 72761-4610
(479) 524-6188
(479) 444-6942
Mailing address
3317 N WIMBERLY DR, FAYETTEVILLE, AR 72703-4056
(479) 521-2752
(479) 521-4603
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100726900B
—
OK
Enumeration date
04/25/2013
Last updated
07/06/2020
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