Provider Demographics
NPI:1518906957
Name:GENERAL ORTHOPAEDICS AND SPINE SERVICES
Entity Type:Organization
Organization Name:GENERAL ORTHOPAEDICS AND SPINE SERVICES
Other - Org Name:CENTRAL ARKANSAS PHYSICIAN SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR PHYSICIAN SERVCIES
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BELFORD
Authorized Official - Suffix:
Authorized Official - Credentials:CHCO CPC CMC
Authorized Official - Phone:501-278-3154
Mailing Address - Street 1:1120 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-7319
Mailing Address - Country:US
Mailing Address - Phone:501-305-2910
Mailing Address - Fax:501-278-3455
Practice Address - Street 1:1120 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-7319
Practice Address - Country:US
Practice Address - Phone:501-305-2910
Practice Address - Fax:501-278-3455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC4667207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5C684Medicare ID - Type UnspecifiedMEDICARE CARE GRP #