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General NPI Number Information
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NPI Number | 1144620683
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Entity Type | Organization
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Legal Business Name | BATESVILLE SPINE AND HEALTH SOLUTIONS LTD
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Dates
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Enumeration Date | 09/03/2014
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Last Update Date | 02/09/2016
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Provider Practice Location Address
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Address Line | 920 HARRISON ST STE A
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City | BATESVILLE
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State | AR
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Zip | 72501-6949
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Country | US
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Telephone | 870-569-4909
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Fax | 870-569-4895
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Provider Business Mailing Address
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Address Line | PO BOX 2731
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City | BATESVILLE
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State | AR
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Zip | 72503-2731
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Country | US
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Telephone | 870-569-4909
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Fax | 870-569-4895
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL JORDAN WEAVER
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Credential | M.D.
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Telephone | 870-569-4909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | E6051
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License Number State | AR
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