Organization
OZARK MOUNTAIN ORTHOPEDIC CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ARTHUR WALLER M.D. (PRESIDENT)
(501) 362-6631
Entity
Organization
Contact information
Practice address
1708 W MAIN ST, HEBER SPRINGS, AR 72543-2823
(501) 362-6631
Mailing address
1708 W MAIN ST, HEBER SPRINGS, AR 72543-2823
(501) 362-6631
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
R-4651
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140217001
—
AR
Enumeration date
12/13/2006
Last updated
05/19/2009
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