Provider Demographics
NPI:1629156252
Name:OZARK ORTHOPAEDIC AND HAND SURGERY CENTER,P.A
Entity Type:Organization
Organization Name:OZARK ORTHOPAEDIC AND HAND SURGERY CENTER,P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:VARELA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-269-8300
Mailing Address - Street 1:PO BOX 1580
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:AR
Mailing Address - Zip Code:72560-1580
Mailing Address - Country:US
Mailing Address - Phone:870-269-8300
Mailing Address - Fax:870-269-5630
Practice Address - Street 1:2110 EAST MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:AR
Practice Address - Zip Code:72560
Practice Address - Country:US
Practice Address - Phone:870-269-8300
Practice Address - Fax:870-269-5630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR129067002Medicaid