MEDICARE: OXYGENS URGENT CARE CENTER P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center	E-0321	AR

General Provider Information

NPI Number	:	1013283290
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OXYGENS URGENT CARE CENTER P.A.

Provider Business Mailing Address
First Line	:	6300 FREE FERRY RD
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-2118
Country	:	US
Telephone Number	:	479-650-9561
Fax Number	:

Provider Business Practice Location Address
First Line	:	4600 TOWSON AVE
Second Line	:	SUITE 101-W-1
City	:	FORT SMITH
State	:	AR
Zip	:	72901-7961
Country	:	US
Telephone Number	:	479-226-3132
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DANNY SILVER
Credential	:	MD
Telephone Number	:	479-650-9561

Provider Enumeration Date	:	04/01/2012
Last Update Date	:	04/01/2012

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