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General NPI Number Information
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NPI Number | 1346534047
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Entity Type | Organization
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Legal Business Name | ARKANSAS FOOT & ANKLE CLINIC, PA
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Dates
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Enumeration Date | 05/31/2011
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 1801 W 40TH AVE SUITE 4E
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City | PINE BLUFF
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State | AR
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Zip | 71603-6940
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Country | US
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Telephone | 870-535-4850
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Fax | 870-535-3558
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Provider Business Mailing Address
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Address Line | 1801 W 40TH AVE SUITE 4E
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City | PINE BLUFF
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State | AR
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Zip | 71603-6940
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Country | US
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Telephone | 870-535-4850
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Fax | 870-535-3558
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. JOHN P THRASH
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Credential |
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Telephone | 870-535-4850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 162
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License Number State | AR
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