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General NPI Number Information
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NPI Number | 1396190401
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Entity Type | Individual
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Provider Name | RYAN DEWITZ
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Gender | Male
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Dates
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Enumeration Date | 04/26/2016
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 2601 GENE GEORGE BLVD
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City | SPRINGDALE
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State | AR
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Zip | 72762-0845
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Country | US
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Telephone | 479-725-6800
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Fax | 479-725-6582
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Provider Business Mailing Address
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Address Line | 1 CHILDRENS WAY # 664
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City | LITTLE ROCK
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State | AR
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Zip | 72202-3500
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Country | US
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Telephone | 501-364-1100
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Fax | 501-978-6436
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | A171762
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | E-16698
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License Number State | AR
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