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NPI Code Detail

MEDICARE: OZARK REGIONAL ANESTHESIA

MEDICARE: OZARK REGIONAL ANESTHESIA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275517468
Entity Type Code : Organization
Provider Name (Legal Business Name) : OZARK REGIONAL ANESTHESIA
Provider Business Mailing Address
First Line : PO BOX 1867
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72702-1867
Country : US
Telephone Number : 918-664-9892
Fax Number : 918-664-2521
Provider Business Practice Location Address
First Line : 3215 N NORTHHILLS BLVD
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-4424
Country : US
Telephone Number : 479-463-1019
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : THOMAS JAY DAVIS
Credential : MD
Telephone Number : 918-728-6145
Provider Enumeration Date : 12/01/2005
Last Update Date : 02/10/2012

Similar Medicare Providers

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Practice Location Address:
3215 N NORTHHILLS BLVD
FAYETTEVILLE, AR
72703-4424
Practice Phone: 479-463-1000
Practice Fax:
1356195374 — SARAH ROSEANN OSBORNE APRN-CNP
Practice Location Address:
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Practice Fax:
1245227057 — GORDON R PARHAM MD
Practice Location Address:
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FAYETTEVILLE, AR
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Practice Phone: 479-463-7102
Practice Fax: 479-463-7864
1083604425 — DR. BARBARA ELAINE ASHE MD
Practice Location Address:
3215 N. NORTH HILLS BLVD.
FAYETTEVILLE, AR
72703-4424
Practice Phone: 479-463-7902
Practice Fax: 479-463-5345
1568446664 — JOHN BRUNNER III MD
Practice Location Address:
3215 N NORTHHILLS BLVD
FAYETTEVILLE, AR
72703-4424
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1295719128 — FREDERIC SPIES MD
Practice Location Address:
3215 N NORTHHILLS BLVD
FAYETTEVILLE, AR
72703-4424
Practice Phone: 918-664-9892
Practice Fax: 918-664-2521

Directions to “OZARK REGIONAL ANESTHESIA ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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