Provider Demographics
NPI:1144238841
Name:PINNACLE ORTHOPEDICS P.A.
Entity Type:Organization
Organization Name:PINNACLE ORTHOPEDICS P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-975-1916
Mailing Address - Street 1:PO BOX 242664
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-0029
Mailing Address - Country:US
Mailing Address - Phone:501-975-1916
Mailing Address - Fax:501-975-1917
Practice Address - Street 1:13100 CHENAL PARKWAY
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-5214
Practice Address - Country:US
Practice Address - Phone:501-975-1916
Practice Address - Fax:501-975-1917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DD1525OtherRAILROAD MEDICARE
5F211OtherBCBS OF ARKANSAS
DD1525OtherRAILROAD MEDICARE