Provider Demographics
NPI:1609419266
Name:NORTH ARKANSAS ORTHOPEDIC & SURGERY ASSOCIATES
Entity Type:Organization
Organization Name:NORTH ARKANSAS ORTHOPEDIC & SURGERY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:D
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-993-6699
Mailing Address - Street 1:1507 LINWOOD DR STE A
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-5818
Mailing Address - Country:US
Mailing Address - Phone:870-335-8063
Mailing Address - Fax:
Practice Address - Street 1:1507 LINWOOD DR STE A
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-5818
Practice Address - Country:US
Practice Address - Phone:870-239-8102
Practice Address - Fax:870-239-8105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty