Healthcare Provider Details

I. General information

NPI: 1891454898
Provider Name (Legal Business Name): ORTHOARKANSAS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2021
Last Update Date: 12/17/2021
Certification Date: 12/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10301 KANIS RD STE 2
LITTLE ROCK AR
72205-6205
US

IV. Provider business mailing address

800 FAIR PARK BLVD
LITTLE ROCK AR
72204-1720
US

V. Phone/Fax

Practice location:
  • Phone: 501-500-3500
  • Fax: 501-904-3620
Mailing address:
  • Phone: 501-500-3500
  • Fax: 501-904-3620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DANA WALKER
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 501-404-8007