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
600 S 21ST ST, FORT SMITH, AR 72901-3915
(479) 274-6750
(479) 434-5395
Mailing address
PO BOX 3528, FORT SMITH, AR 72913-3528
(479) 274-2000
(479) 274-2194
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
MC-0254
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191274716
—
AR
Enumeration date
11/06/2009
Last updated
09/01/2015
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