MEDICARE: NORTH ARKANSAS ORTHOPEDIC & SURGERY ASSOCIATES

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	207XS0117X	Orthopaedic Surgery of the Spine Physician

General Provider Information

NPI Number	:	1609419266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH ARKANSAS ORTHOPEDIC & SURGERY ASSOCIATES

Provider Business Mailing Address
First Line	:	1507 LINWOOD DR STE A
Second Line	:
City	:	PARAGOULD
State	:	AR
Zip	:	72450-5818
Country	:	US
Telephone Number	:	870-335-8063
Fax Number	:

Provider Business Practice Location Address
First Line	:	1507 LINWOOD DR STE A
Second Line	:
City	:	PARAGOULD
State	:	AR
Zip	:	72450-5818
Country	:	US
Telephone Number	:	870-239-8102
Fax Number	:	870-239-8105

Authorized Official
Title or Position	:	OWNER
Name	:	TRAVIS D RICHARDSON
Credential	:
Telephone Number	:	815-993-6699

Provider Enumeration Date	:	10/25/2019
Last Update Date	:	10/25/2019

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