Healthcare Provider Details

I. General information

NPI: 1043305501
Provider Name (Legal Business Name): OZARK HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 HWY 65 S
CLINTON AR
72031
US

IV. Provider business mailing address

PO BOX 206
CLINTON AR
72031-0206
US

V. Phone/Fax

Practice location:
  • Phone: 501-745-7000
  • Fax: 501-745-9741
Mailing address:
  • Phone: 501-745-7000
  • Fax: 501-745-9741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number4237
License Number StateAR

VIII. Authorized Official

Name: DAVID DEATON
Title or Position: ADMINISTRATOR/CEO
Credential:
Phone: 501-745-9531