Organization
NORTHWEST ARKANSAS SURGICAL CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT PETRINO M.D. (PHYSICIAN)
(479) 751-3202
Entity
Organization
Contact information
Practice address
724 DEAVER ST, SPRINGDALE, AR 72764-5356
(479) 751-3202
(479) 756-2721
Mailing address
724 DEAVER ST, SPRINGDALE, AR 72764-5356
(479) 751-3202
(479) 756-2721
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100727600A
—
OK
05
—
106416002
—
AR
Enumeration date
08/10/2006
Last updated
06/16/2014
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