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General NPI Number Information
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NPI Number | 1093799405
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Entity Type | Organization
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Legal Business Name | ORTHOARKANSAS SURGERY CENTER LLC
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 12/11/2013
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Provider Practice Location Address
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Address Line | 10301 KANIS RD
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City | LITTLE ROCK
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State | AR
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Zip | 72205-6205
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Country | US
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Telephone | 501-604-4150
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Fax | 501-604-4127
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Provider Business Mailing Address
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Address Line | 10301 KANIS RD
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City | LITTLE ROCK
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State | AR
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Zip | 72205-6205
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Country | US
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Telephone | 501-604-4150
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Fax | 501-604-4127
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Authorized Official
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Title or Position | FINANCIAL MANAGER
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Name | MS. GRETCHEN MARCHESE
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Credential | CPC
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Telephone | 501-604-4150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | AR3758
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License Number State | AR
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