MEDICARE: REGIONAL ORTHOPAEDIC HEALTH CARE

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
1	207X00000X	Orthopaedic Surgery Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CG0920	OTHER	AR	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	5B111	OTHER	AR	BCBS

General Provider Information

NPI Number	:	1568477123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGIONAL ORTHOPAEDIC HEALTH CARE

Provider Business Mailing Address
First Line	:	3 MEDICAL PLZ
Second Line	:
City	:	MOUNTAIN HOME
State	:	AR
Zip	:	72653-2918
Country	:	US
Telephone Number	:	870-424-3400
Fax Number	:	870-424-4121

Provider Business Practice Location Address
First Line	:	3 MEDICAL PLZ
Second Line	:
City	:	MOUNTAIN HOME
State	:	AR
Zip	:	72653-2918
Country	:	US
Telephone Number	:	870-424-3400
Fax Number	:	870-424-4121

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	RUSSELL B. RAULS
Credential	:	MD
Telephone Number	:	870-424-3400

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	09/09/2024

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Directions to “REGIONAL ORTHOPAEDIC HEALTH CARE ” Practice Location

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