Healthcare Provider Details

I. General information

NPI: 1588464002
Provider Name (Legal Business Name): OZARK CONCIERGE CLINIC,PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2025
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5206 W VILLAGE PKWY STE 10
ROGERS AR
72758-8137
US

IV. Provider business mailing address

5206 W VILLAGE PKWY STE 10
ROGERS AR
72758-8137
US

V. Phone/Fax

Practice location:
  • Phone: 479-379-1201
  • Fax:
Mailing address:
  • Phone: 479-379-1201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM M ROGERS
Title or Position: OWNER/DOCTOR
Credential: MD
Phone: 479-379-1201