Healthcare Provider Details

I. General information

NPI: 1386638401
Provider Name (Legal Business Name): JAMES PETER VAKOS PT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/02/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1090 ARNOLD DR 314 MDOS/SGOKY
LITTLE ROCK AFB AR
72099-4933
US

IV. Provider business mailing address

3468 E KIEHL AVE #6807
SHERWOOD AR
72120-3316
US

V. Phone/Fax

Practice location:
  • Phone: 501-987-7466
  • Fax:
Mailing address:
  • Phone: 501-835-6210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number1923
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number1387
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: