Provider Demographics
NPI:1568659209
Name:ORTHOPAEDICS, P.A.
Entity Type:Organization
Organization Name:ORTHOPAEDICS, P.A.
Other - Org Name:RIVER VALLEY PROSTHETICS & ORTHOTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-709-7002
Mailing Address - Street 1:3501 W. E. KNIGHT DRIVE
Mailing Address - Street 2:P.O. BOX 11230
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72917-1230
Mailing Address - Country:US
Mailing Address - Phone:479-709-7000
Mailing Address - Fax:479-709-7030
Practice Address - Street 1:3501 W. E. KNIGHT DRIVE
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72917-1230
Practice Address - Country:US
Practice Address - Phone:479-709-7000
Practice Address - Fax:479-709-7030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies