Healthcare Provider Details

I. General information

NPI: 1699198085
Provider Name (Legal Business Name): WILLIAM KEITH JOINER OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2014
Last Update Date: 01/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 HINSON RD
EL DORADO AR
71730-8088
US

IV. Provider business mailing address

2600 HINSON RD
EL DORADO AR
71730-8088
US

V. Phone/Fax

Practice location:
  • Phone: 870-918-3173
  • Fax:
Mailing address:
  • Phone: 870-918-3173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTR1651
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: