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General NPI Number Information
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NPI Number | 1831080381
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Entity Type | Organization
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Legal Business Name | BATESVILLE SURGICAL ARTS LLC
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Dates
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Enumeration Date | 07/14/2025
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 2040 FITZHUGH ST
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City | BATESVILLE
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State | AR
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Zip | 72501-7409
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Country | US
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Telephone | 870-307-3790
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Fax | 870-376-3551
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Provider Business Mailing Address
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Address Line | 2517 HARRISON ST # 308
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City | BATESVILLE
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State | AR
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Zip | 72501-7424
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Country | US
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Telephone | 870-307-3790
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Fax | 870-376-3551
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Authorized Official
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Title or Position | OWNER
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Name | PHILIP PACK
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Credential | DO
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Telephone | 786-519-9572
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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