Organization
OZARK FOOT & ANKLE PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES J BRANTLEY DPM (MANAGING MEMBER)
(479) 549-3835
Entity
Organization
Contact information
Practice address
2828 E MILLENNIUM PL, SUITE 2, FAYETTEVILLE, AR 72703-6514
(479) 582-1199
(479) 582-1194
Mailing address
PO BOX 8728, FAYETTEVILLE, AR 72703-0013
(479) 549-3835
(479) 549-4146
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
811005690
SECRETARY OF STATE-DEPT OF CORPORATIONS
AR
Enumeration date
12/15/2011
Last updated
08/09/2013
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