Organization
COOPER CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CURTIS RALSTON (CFO)
(479) 274-2000
Entity
Organization
Contact information
Practice address
7306 ROGERS AVE, FORT SMITH, AR 72903-4164
(479) 274-2000
(479) 274-2194
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
80
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191272716
—
AR
Enumeration date
07/30/2012
Last updated
10/20/2015
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