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General NPI Number Information
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NPI Number | 1598463572
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Entity Type | Organization
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Legal Business Name | OZARK PELVIC HEALTH, LLC
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 19 MEDICAL PLZ STE 10
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-2918
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Country | US
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Telephone | 870-232-0948
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Fax | 870-232-0898
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Provider Business Mailing Address
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Address Line | 19 MEDICAL PLZ STE 10
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-2962
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Country | US
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Telephone | 870-232-0948
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Fax | 870-232-0898
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Authorized Official
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Title or Position | MANAGING MEMBER/AUTHORIZED OFFICIAL
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Name | WILLIAM COREY SMITH
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Credential | MD
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Telephone | 870-232-0948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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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 | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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