Healthcare Provider Details

I. General information

NPI: 1629156252
Provider Name (Legal Business Name): OZARK ORTHOPAEDIC AND HAND SURGERY CENTER,P.A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 EAST MAIN ST
MOUNTAIN VIEW AR
72560
US

IV. Provider business mailing address

PO BOX 1580
MOUNTAIN VIEW AR
72560-1580
US

V. Phone/Fax

Practice location:
  • Phone: 870-269-8300
  • Fax: 870-269-5630
Mailing address:
  • Phone: 870-269-8300
  • Fax: 870-269-5630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES DEAN VARELA
Title or Position: PHYSICIAN
Credential: MD
Phone: 870-269-8300