MEDICARE: MR. JAMES PETER VAKOS PT

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	2251X0800X	Orthopedic Physical Therapist	1923	WI
2	2251X0800X	Orthopedic Physical Therapist	1387	NV

General Provider Information

NPI Number	:	1386638401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES PETER VAKOS PT

Provider Business Mailing Address
First Line	:	3468 E KIEHL AVE
Second Line	:	#6807
City	:	SHERWOOD
State	:	AR
Zip	:	72120-3316
Country	:	US
Telephone Number	:	501-835-6210
Fax Number	:

Provider Business Practice Location Address
First Line	:	1090 ARNOLD DR
Second Line	:	314 MDOS/SGOKY
City	:	LITTLE ROCK AFB
State	:	AR
Zip	:	72099-4933
Country	:	US
Telephone Number	:	501-987-7466
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	09/11/2025

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