Provider Demographics
NPI:1326546672
Name:ORTHOARKANSAS, PA
Entity Type:Organization
Organization Name:ORTHOARKANSAS, PA
Other - Org Name:ARKANSAS SPECIALTY MRI CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-500-3500
Mailing Address - Street 1:3480 LANDERS RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2541
Mailing Address - Country:US
Mailing Address - Phone:501-978-2623
Mailing Address - Fax:501-978-2630
Practice Address - Street 1:3480 LANDERS RD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2541
Practice Address - Country:US
Practice Address - Phone:501-978-3135
Practice Address - Fax:501-978-3138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-31
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMC1964174400000X
261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty