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Organization

COOPER CLINIC PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CURTIS RALSTON (CEO)
(479) 274-2000
Entity
Organization

Contact information

Practice address
6801 ROGERS AVE, FORT SMITH, AR 72903-4067
(479) 274-3500
(479) 274-3599
Mailing address
PO BOX 3528, FORT SMITH, AR 72913-3528
(479) 274-2000
(479) 274-2194

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MC-0254
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
125018002
AR
Enumeration date
05/07/2007
Last updated
09/01/2015
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