Healthcare Provider Details

I. General information

NPI: 1497023147
Provider Name (Legal Business Name): REEVES SPINE AND ORTHOPEDIC,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2011
Last Update Date: 12/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 W. ERIE
HARRISON AR
72601
US

IV. Provider business mailing address

224 W. ERIE
HARRISON AR
72601
US

V. Phone/Fax

Practice location:
  • Phone: 870-741-8289
  • Fax: 870-741-0308
Mailing address:
  • Phone: 870-741-8289
  • Fax: 870-741-0308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberE7280
License Number StateAR

VIII. Authorized Official

Name: CHRIS RYAN REEVES
Title or Position: OWNER
Credential: D.O.
Phone: 870-741-8289