Provider Demographics
NPI:1568477123
Name:REGIONAL ORTHOPAEDIC HEALTH CARE
Entity Type:Organization
Organization Name:REGIONAL ORTHOPAEDIC HEALTH CARE
Other - Org Name:KNOX ORTHOPAEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORTHOPAEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:KNOX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-424-3400
Mailing Address - Street 1:3 MEDICAL PLZ
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-2918
Mailing Address - Country:US
Mailing Address - Phone:870-424-3400
Mailing Address - Fax:870-424-4121
Practice Address - Street 1:3 MEDICAL PLZ
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-2918
Practice Address - Country:US
Practice Address - Phone:870-424-3400
Practice Address - Fax:870-424-4121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMC1047207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5B111OtherBCBS
AR138975002Medicaid
ARCG0920OtherRR MEDICARE
ARCG0920OtherRR MEDICARE
AR5B111OtherBCBS