Organization
OUACHITA SURGICAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS JOHN TINNESZ M.D. (GENERAL SURGEON)
(479) 394-1414
Entity
Organization
Contact information
Practice address
400 CRESTWOOD CIR, SUITE P, MENA, AR 71953-5512
(479) 394-1414
(479) 394-2612
Mailing address
400 CRESTWOOD CIR, SUITE P, MENA, AR 71953-5512
(479) 394-1414
(479) 394-2612
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R3688
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020035810
RAILROAD MEDICARE
AR
05
—
100728320A
—
OK
05
—
132816002
—
AR
01
—
50830
BLUE CROSS BLUE SHIELD
AR
Enumeration date
05/31/2006
Last updated
06/10/2008
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