Organization
SPRINGDALE FOOT SPECIALIST PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD R PINKERTON (PRESIDENT)
(479) 751-3656
Entity
Organization
Contact information
Practice address
1213 S THOMPSON ST, SPRINGDALE, AR 72764-6313
(479) 751-3656
(479) 750-2221
Mailing address
1213 S THOMPSON ST, SPRINGDALE, AR 72764-6313
(479) 751-3656
(479) 750-2221
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
121
OK
332B00000X
Durable Medical Equipment & Medical Supplies
69
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106361717
—
AR
05
—
200052700A
—
OK
01
—
442460675
MEDICARE - OK
OK
01
—
480032388
MCRR
AR
01
—
56364
PTAN
AR
Enumeration date
05/23/2008
Last updated
06/06/2008
Update your record
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